淮安地区92例输入性疟疾临床分析

Clinical Analysis of 92 Cases of Imported Malaria in Huai＇an Area

【目的】分析淮安地区输入性疟疾的临床特点，探索该病的早期识别、治疗及预后。【方法】对2008年1月至2012年6月住本院治疗的92例输入性疟疾病例进行回顾性分析。【结果】92例患者中，畏寒发热92例（100。％）；呕吐23例（25％）；腹泻14例（15．2％）；肢体抽动、眼球震颤、及意识障碍6例（6．5％）；酱油色尿、巩膜黄染、贫血貌等溶血性贫血表现9例（9．8Yoo）；尿量减少、无尿、肾区叩痛5例（5．4％）；外周血白细胞总数升高12例（13％）；血红蛋白〈90g／L22例（23．9％）；谷草转氨酶和谷丙转氨酶高于正常23例（25％）；肾功能损害5例（5．4％）；脾大39例（42．4％）；胸片表现为实变征象者12例（13％）。菁蒿素衍生物治疗效果好，治愈率为98．9％，1例脑型疟疾患者死亡。【结论】输入性疟疾患者临床表现复杂，并发症多，病情凶险．早期诊断，及时、合理的处理是治疗恶性疟疾的关键。菁蒿素衍生物可作为脑型疟疾和恶性疟疾的首选药物。

[Objective] To analyzes the clinical features of imported malaria in Huai＇an area, and to explore the early diagnosis, treatment and prognosis of the disease. [Methods] Totally 92 cases of imported malaria treated in our hospital from Jan. 2008 to June 2012 were analyzed retrospectively. [Results]Of the 92 patients, 92 patients （100%） had chilly and fever, and 23 patients（25%） had vomiting, and 14 patients（15.2%） had diarrhea, and 6 patients（6.5 % ） had limbs twitching, nystagmus and disturbance of consciousness, and 9 patients（9.8 % ） had he- molytic anemia manifestations such as soy sauce urine, yellow sclera and the appearance of anemia, and 5 patients （ 5.4 % ） had hypourocrinia, anuria and percussion pain in renal region, and 12 patients（13 %） had peripheral blood leucocyte elevation, and 22 patients（23.9%） had Hb〈90g/L, and 23 patients（25%） had AST and ALT above the normal level, and 5 patients（5.4 % ） had renal dysfunction, and 39 patients（42.4 % ） had splenomegaly, and 12 patients（13 %） had the consolidation signs by chest film. Artemisinin derivatives had good efficacy, and the cure rate was 98.9 %. One case with cerebral malaria died. [Conclusion] Imported malaria patients have the complicated clinical manifestations, many complications and fatal condition. Early diagnosis and prompt and suitable treatment are the key to treat falciparum malaria. Artemisinin derivatives can be used as the first choice of drugs for the trea.tment of cerebral malaria and falciparum Malaria.