儿童肺吸虫感染所致多浆膜腔积液和肺吸虫脑病九例临床分析

Polyserositis and Cerebral Paragonimiasis Caused by Paragonimus Infection in Children:A clinical analysis of 9 cases

目的分析儿童肺吸虫病的临床表现,以提高临床诊治水平。方法回顾2000—2008年在我院确诊的9例肺吸虫患儿,分析其病史、临床表现、实验室检查及诊疗情况。结果7例为多浆膜腔积液,表现为不同程度的胸腔积液、腹腔积液,5例合并不同程度的心包积液。1例为肺吸虫脑病,1例同时存在多浆膜腔积液和肺吸虫脑病,9例外周血嗜酸粒细胞增高,5例血清IgE检测均明显高于正常,6例行肺吸虫抗原皮试阳性,3例肺吸虫血清抗体阳性。结论小儿肺吸虫病临床表现复杂,应注意询问生食溪蟹或蝲蛄病史,结合患儿临床表现、血嗜酸粒细胞增多、肺吸虫抗原皮试明确诊断以免误诊。

Objective To analyze the clinical manifestations of children＇s paragonimiasis in order to enhance the level of clinical diagnosis and treatment.Methods The medical history,clinical manifestations,results of laboratory examination,conditions of diagnosis and treatment of 9 confirmed patients with paragonimiasis from 2000 to 2008 in our hospital were retrospectively analyzed.Results There were 7 cases of polyserositis such as pleural effusion and ascites in a different degrees,5 cases complicated by pericardial effusion.There was one case of cerebral paragonimiasis,and one case who had both polyserositis and cerebral Paragonimiasis,nine cases of peripheral blood eosinophilia,five cases whose serum IgE were significantly higher than normal,six cases whose paragonimiasis antigen intradermal test was positive,three cases whose paragonimiasis serum antibody was positive.Conclusion The clinical manifestations of paragonimiasis is complex in children.The diagnosis should be determined by inquiring the patients about history of ingestion of raw or partially cooked freshwater crabs or crawfish,combining with clinical manifestations of the patients,eosinophilia,and paragonimus antigen intradermal test in order to avoid misdiagnosis.