摘要
目的回顾性分析不典型华支睾吸虫病的临床表现、影像学和实验室检查特征,以减少华支睾吸虫病的漏诊和误诊。方法通过对我院新近就诊的1例罕见华支睾吸虫病患者的流行病学史、临床表现、影像学检查、实验室血清学及病原学检查情况的详尽分析,归纳总结华支睾吸虫病的不典型临床表现和实验室检查特点。结果此例患者临床症状不典型,血液学和影像学检查均无特异性,多次粪便检查均检出华支睾吸虫卵,确诊慢性华支睾吸虫病。结论在华支睾吸虫病的非流行区,如患者有生食淡水鱼生史并出现不明原因消化道症状、肝功异常、胆囊炎、胆囊胆管结石或肝硬化等,需要提高华支睾吸虫病的鉴别诊断意识,注重流行病学史尤其是饮食活动的调查,并重视粪便中多次仔细查找病原学依据,减少华支睾吸虫病的临床漏诊和误诊,达到早诊断早治疗的目的。
Objective To reduce the misdiagnosis and missed diagnosis of clonorchiasis sinensis, the clinical manifestations, imaging and laboratory features of atypical clonorchiasis sinensis were retrospectively analyzed. Methods The clinical manifestations and laboratory examination characteristics of the disease were summarized through the detailed analysis of epidemiological history, clinical manifestations, imaging examination, laboratory serology and etiological examination of a rare case of clonorchiasis sinensis in our hospital. Results The clinical symptoms of this patient were atypical, and the hematological and imaging examinations were not specific. The eggs of clonorchis sinensis were detected by many stool examinations, and the diagnosis of chronic clonorchiasis sinensis was confirmed. Conclusion In the non-endemic areas of clonorchiasis sinensis, if the patients has a history of raw freshwater fish and unexplained digestive tract symptoms, abnormal liver function, cholecystitis, cholecystolithiasis or cirrhosis of the liver, it is necessary to improve the awareness of differential diagnosis of clonorchiasis sinensis, focusing on the epidemiological history, especially the investigation of dietary activities, and paying attention to multiple examination of the etiological basis in feces. Reduce the clinical missed diagnosis and misdiagnosis of clonorchiasis sinensis, and achieve the purpose of early diagnosis and treatment.
作者
赖小华
王燕凤
LAI Xiaohua;WANG Yanfeng(Department of Laboratory,The FirstAffiliated Hospital of Xiamen University,Xiamen Fujian 361000,China)
出处
《中国卫生标准管理》
2019年第9期70-73,共4页
China Health Standard Management
关键词
华支睾吸虫
华支睾吸虫病
肝吸虫
食源性寄生虫病
华支睾吸虫卵
人兽共患
吡喹酮
clonorchis sinensis
clonorchiasis sinensis
liver fluke
foodborne parasitic diseases
eggs of clonorchis sinensis
zoonosis
praziquantel
