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血吸虫病:对全球旅行者及医疗服务提供者的影响

Schistosomiasis: implications for world travelers and healthcare providers.

作者信息

Greenwald Beverly

机构信息

Department of Nursing, North Dakota State University, Fargo, 58105-5055, USA.

出版信息

Gastroenterol Nurs. 2005 May-Jun;28(3):203-5; quiz 206-7. doi: 10.1097/00001610-200505000-00002.

Abstract

Schistosomiasis ranks second, behind malaria, among human parasitic diseases in terms of public health and socioeconomic importance in tropical and sub-tropical areas. Worldwide, 1 of 30 people has schistosomiasis. Up to 300 million people are infected, and 600 million live in environments where infection is a risk. Tourists from non-endemic areas are contracting schistosomiasis due to the rise in "off-the-beaten-track" tourism. Praziquantel is effective against all species of schistosomes and early treatment is curative. Schistosomiasis is an insidious disease, however, so worldwide the disease is not diagnosed early. The most frequent and dangerous complication of the disease is variceal hemorrhage due to hepatic fibrosis. Variceal hemorrhage is the first symptom in 58% of cases. A variety of treatments for variceal hemorrhage are available. Exsanguination from variceal hemorrhage is possible; therefore, aggressive stabilization of the patient by the use of multiple therapies is appropriate. Most patients treated after esophageal hemorrhages do not experience reversal of hepatic fibrosis. For this reason, healthcare providers need an increased awareness of schistosomiasis to enable earlier detection and treatment in world travelers.

摘要

在热带和亚热带地区,就公共卫生和社会经济重要性而言,血吸虫病在人类寄生虫病中位列第二,仅次于疟疾。在全球范围内,每30人中就有1人感染血吸虫病。多达3亿人受到感染,6亿人生活在有感染风险的环境中。由于“小众”旅游的兴起,来自非流行地区的游客也感染了血吸虫病。吡喹酮对所有血吸虫种类均有效,早期治疗可治愈。然而,血吸虫病是一种隐匿性疾病,因此在全球范围内该疾病都未能得到早期诊断。该疾病最常见且危险的并发症是肝纤维化导致的静脉曲张出血。静脉曲张出血是58%病例的首发症状。针对静脉曲张出血有多种治疗方法。静脉曲张出血可能导致失血性休克,因此,采用多种疗法积极稳定患者病情是恰当的。大多数在食管出血后接受治疗的患者肝纤维化并未逆转。因此,医疗服务提供者需要提高对血吸虫病的认识,以便在全球旅行者中更早地发现和治疗该病。

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