儿童吸虫病15例临床分析

Clinical analysis of 15 children with trematodiasis

目的分析儿童吸虫病的临床特征，以提高临床诊治水平。方法回顾性分析2002至2017年上海儿童医学中心确诊的15例不同类型的儿童吸虫病患儿的临床资料，分析其病史、临床表现、实验室检查及诊疗情况。结果7例患儿有明确的生食、吃醉溪蟹虾史，2例有饮用生溪水和捕捉溪蟹史。5例患儿为多浆膜腔积液，表现为不同程度的胸腔积液、腹腔积液和心包积液。11例（73．3％）患JD#b周血嗜酸性粒细胞升高，10例（76．9％）血清总IgE升高（共13例患儿行免疫球蛋白检测）。15例吸虫血清抗体阳性，1例粪便华支睾吸虫阳性。15例患儿均予吡喹酮治疗后好转出院。结论儿童吸虫病临床表现复杂多样，临床医师需提高对本病的认识，避免误诊误治；吡喹酮治疗吸虫病疗效较好。

Objective To analyze the clinical characteristics of children＇s trematodiasis 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 15 confirmed different types of children with trematodiasis from 2002 to 2017 in Shanghai Children＇s Medical Center were retrospectively analyzed. Results Seven cases had eaten raw or undercooked freshwater crab, and 2 cases often drank raw stream or caught crabs. Five cases had polyserositis such as pleural effusion, ascites and pericardial effusion in different degrees. The eosinophil counts of 11 cases （73.3%） and IgE of 10 cases （76. 9% ） increased. Fifteen cases, trematodiasis serum antibody tests were positive,and 1 case＇s fecal clonorchiasis was positive. Fifteen cases were improved by praziquantel. Conclusion The clinical characteristics of childhood trematodiasis are complex and atypical. Trematodiasis should be understood more deeply for clinician to avoid misdiagosis. Praziquantel is a safe and effective drug for trematodiasis.