摘要
景洪市第一人民医院于2016年6月23日收治1例18岁男性泌尿系疾病患者,因尿急、尿频、尿痛、血尿就诊,入院后查体一般情况良好。实验室检查血常规和肝、肾脏等功能指标无异常,粪便常规检查见微小膜壳绦虫卵,泌尿系疾病治愈后,患者自觉无明显消化道症状出院。2019年2月12日随访患者自诉近1年消化功能差,腹泻,偶有腹痛。粪便常规显示微小膜壳绦虫卵密度较前明显增加,并查见大量蓝氏贾第鞭毛虫包囊,确诊微小膜壳绦虫和蓝氏贾第鞭毛虫混合感染。先后通过替硝唑、槟榔南瓜子及吡喹酮等手段进行驱虫治疗,根据显微镜检查结果比较不同驱虫方法的利弊,结果显示,替硝唑仅对蓝氏贾第鞭毛虫治疗有效;吡喹酮可有效杀灭肠道中微小膜壳绦虫成虫和肠黏膜内的似囊尾蚴,具有较好的治疗效果;通过追踪患者生活环境,分析感染来源及预防措施,提示未经无害化处理的农肥和不良生活卫生习惯可能是寄生虫感染的主要因素。
On June 23,2016,a 18-year-old male patient with urinary system disease was admitted to The First People's Hospital of Jinghong City,he was treated for urgency,frequent urination,dysuria and hematuria,after admission,he was generally in good physical condition.Laboratory examination showed no abnormalities in blood routine,liver,kidney and other functional indicators,fecal routine examination showed eggs of Hymenolepis nana,after the urinary system disease was cured,the patient was discharged without obvious gastrointestinal symptoms.On February 12,2019,the follow-up patient complained of poor digestive function,diarrhea and occasional abdominal pain for nearly one year.The stool routine showed that the egg density of Hymenolepis nana was significantly higher than that before,and a large number of cysts of Giardia lamblia were found,the mixed infection of Hymenolepis nana and Giardia lamblia was confirmed.Tinidazole,areca pumpkin seeds and praziquantel were used for deworming treatment successively,the advantages and disadvantages of different deworming methods were compared according to the results of microscopic examination,the results showed that tinidazole was only effective for the treatment of Giardia lamblia,praziquantel can effectively kill the adults of Hymenolepis nana in the intestine and the cysticercus-like larvae in the intestinal mucosa,and has good therapeutic effect;by tracking the patient's living environment,analyzing the source of infection and preventive measures,it is suggested that agricultural fertilizer and poor living hygiene habits without harmless treatment may be the main factors of parasitic infection.
作者
王家军
罗嫚
黄洁
钱江勐
余超
WANG Jiajun;LUO Man;HUANG Jie;QIAN Jiangmeng;YU Chao(Department of Clinical Laboratory,The First People's Hospital of Jinghong City,Xishuangbanna,Yunnan,666100,China;Department of Clinical Laboratory,Xishuangbanna Dai Autonomous Prefecture People's Hospital,Xishuangbanna,Yunnan,666100,China)
出处
《当代医学》
2024年第19期5-8,共4页
Contemporary Medicine
关键词
微小膜壳绦虫
槟榔南瓜籽
吡喹酮
Hymenolepis nana
Areca nut pumpkin seed
Praziquantel
