本文選題：埃及血吸蟲病 + 膀胱腫瘤�。� 參考：《中國全科醫(yī)學(xué)》2017年08期

【摘要】：目的探討埃及血吸蟲病的流行病學(xué)、臨床特征及治療方法,避免誤診。方法回顧性分析浙江省臺(tái)州醫(yī)院2016年5月收治的2例埃及血吸蟲病患者的臨床資料,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果患者1,男,53歲,因勞務(wù)輸出至非洲尼日利亞工作,2016年4月回國。主訴間歇性無痛性終末血尿1年。查體無特殊。泌尿系CT檢查:右側(cè)輸尿管及右腎積水,膀胱壁增厚,考慮膀胱腫瘤。B超示:膀胱壁增厚。血常規(guī)示:嗜酸粒細(xì)胞計(jì)數(shù)升高,嗜酸粒細(xì)胞分?jǐn)?shù)明顯升高。行膀胱鏡檢查+活檢術(shù),考慮尿路上皮增生伴亞急性炎及寄生蟲卵(血吸蟲卵首先考慮);尿沉渣鏡檢確診后放置輸尿管D-J管�；颊�2,男,52歲,與患者1同期去非洲工作,同期回國。主訴:無痛性間歇性血尿1個(gè)月。查體無特殊,B超、泌尿系CT均表現(xiàn)為膀胱壁增厚,未見腎積水。行膀胱鏡檢查+活檢術(shù),考慮嗜酸性膀胱炎,未見蟲卵;尿沉渣鏡檢確診。2例患者尿中均發(fā)現(xiàn)有尾刺的蟲卵確診,口服吡喹酮1個(gè)療程,1周后復(fù)查尿沉渣鏡檢,均未見蟲卵。結(jié)論在診治有血尿癥狀的援非歸國人員時(shí),應(yīng)結(jié)合流行病學(xué)資料,避免誤診,結(jié)合吡喹酮抗血吸蟲藥物化療,一般預(yù)后良好。
[Abstract]:Objective to investigate the epidemiology, clinical features and treatment of schistosomiasis in order to avoid misdiagnosis. Methods the clinical data of 2 cases of schistosomiasis in Taizhou Hospital of Zhejiang Province in May 2016 were analyzed retrospectively. Results patient 1, male, 53 years old, returned to Nigeria in April 2016 because of labor export to work in Nigeria. The main complaint was intermittent painless terminal hematuria for 1 year. There is no special examination. Urinary system CT examination: right ureter and right kidney hydronephrosis, bladder wall thickening, considering bladder tumor. B ultrasound: bladder wall thickening. Blood routine showed that eosinophil count increased and eosinophil fraction increased significantly. Cystoscopy was performed to consider ureteral epithelial hyperplasia with subacute inflammation and parasite eggs (Schistosoma japonicum eggs were first considered) and ureteral D-J tube was placed after ureteroscopy. Patient 2, male, 52 years old, and patient 1 at the same time to work in Africa, at the same time return home. Main complaint: painless intermittent hematuria for 1 month. There was no special examination, B-ultrasonography and urological CT showed thickening of bladder wall and no hydronephrosis. Cystoscopy was performed, and no egg was found in eosinophilic cystitis, but no eggs were found in the urine of 2 patients diagnosed by urinary sediment examination, and no eggs were found in urine after a course of one course of oral praziquantel. Conclusion in the diagnosis and treatment of non-returnees with hematuria symptoms, we should combine epidemiological data, avoid misdiagnosis, and combine praziquantel anti-schistosomiasis drug chemotherapy, the general prognosis is good.
【作者單位】： 浙江省臺(tái)州醫(yī)院泌尿外科;浙江省臺(tái)州醫(yī)院病理科;浙江省臺(tái)州醫(yī)院檢驗(yàn)科;
【分類號(hào)】：R532.21

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