胆汁涂片镜检法发现27例华支睾吸虫病的临床分析

Clinical analysis of 27 patients with Clonorchiasis detected by microscopic examination of bile

目的通过对胆汁涂片镜检法发现27例华支睾吸虫病的病例进行临床分析,总结胆汁涂片镜检法在华支睾吸虫病的诊断经验,为华支睾吸虫防控提供思路。方法回顾性分析香港大学深圳医院2018年1月至2021年5月通过胆汁涂片镜检法发现的27例华支睾吸虫病患者的临床表现、实验室检查、影像学检查及治疗经过。结果16例(59.26%)患者有进食生鱼或者生虾史,临床主诉主要是右上腹隐痛或不适、皮肤黄染、发热等;大多数患者的肝功能、嗜酸性粒细胞值及C-反应蛋白正常,入院及术中诊断、影像学检查均未提示华支睾吸虫感染,术中留取胆汁行胆汁涂片镜检法发现华支睾吸虫卵后补充诊断,并给予驱虫治疗。结论肝胆系统疾病患者行手术治疗时,建议常规留取胆汁行胆汁涂片镜检法查虫卵或寄生虫,可有效提高对华支睾吸虫病及其他寄生虫的诊断,减少漏诊。

Objective To summarize microscopic examination of bile in the diagnosis of Clonorchiasis sinensis by analyzing 27 cases of Clonorchiasis,to provide ideas for prevention and control of Clonorchiasis sinensis.Methods The clinical manifestations,laboratory examinations,imaging examinations and treatment of 27 patients with Clonorchiasis sinensis diagnosed by microscopic examination of bile in Shenzhen Hospital of the University of Hong Kong from January 2018 to May2021 were retrospectively analyzed.Results 16 patients(59.26%)had a history of eating raw fish or shrimp.The main clinical complaints were dull pain or discomfort in the right upper abdomen,jaundice,fever.The liver function,eosinophil values and C-reactive protein of most patients were normal,and no infection of Clonorchis sinensis was found in admission,intraoperative diagnosis and imaging examination.During the operation,bile was collected for microscopic examination to find ova of Clonorchis sinensis,antiparasitic therapy was given followed by supplementary diagnosis.Conclusions When patients with hepatobiliary diseases are undergoing operation,suggested routinely send bile to do microscopic examination,which can effectively improve the diagnosis of clonorchiasis and other parasites and reduce missed diagnoses.