15例曼氏裂头蚴病临床分析

Clinical features of 15 cases of sparganosis

目的分析15例曼氏裂头蚴病患者的临床特征,提高对曼氏裂头蚴病的临床诊治水平。方法收集2008-2018年在中南大学湘雅二医院住院治疗的15例确诊为曼氏裂头蚴感染患者资料,回顾性分析患者的流行病学和临床特征。结果 15例患者中,4例喜食烧烤,3例曾食用未熟蛇肉,3例常饮用生水,2例食用生蟹,1例饮生鸡血;白细胞及嗜酸性粒细胞升高患者6例;外周血及脑脊液免疫球蛋白IgG测定高于参考值患者4例;13例裂头蚴抗体阳性;9例颅内曼氏裂头蚴病患者,4例颅内压升高,主要表现为头痛、癫痫,4例脑脊液生化指标异常;治愈9例,好转6例,手术7例。结论曼氏裂头蚴病临床表现多样,应以流行病资料和临床表现为基础,结合实验室及影像学鉴别诊断。

Objective To analyze the clinical features of 15 patients with sparganosis in order to improve the diagnosis and treatment level of the disease. Methods The epidemic data and clinical features of 15 sparganosis patients in the Second Xiangya Hospital Central South University, 2008-2018 were retrospectively analyzed. Results Among the 15 patients, 4 cases liked to barbecue, 3 cases had eaten uncooked snake meat, 3 cases often drank raw water, 2 cases ate raw crab and 1 case drank raw chicken blood;white blood cells and eosinophils increased in 6 cases;immunoglobulin IgG in peripheral blood and cerebrospinal fluid was higher than the reference value in 4 patients;13 patients were diagnosed by serologic antibody test;there were 9 cases of intracranial metacercaria mansoni, 4 cases of intracranial hypertension, mainly manifested by headache and epilepsy, and 4 cases of abnormal cerebrospinal fluid biochemical indicators;9 cases were cured and 6 alleviated after treatment, 7 cases of surgery. Conclusions Because of the variety of clinical features of sparganosis, the diagnosis should be based on epidemiological data and clinical manifestations, combined with laboratory and imaging.