Zhang Jian-Feng, Wen Li-Yong, Zhu Ming-Dong, Yan Xiao-Lan, Chen Wen, Li Li, Lin Li-Jun, Yu Li-Ling
Institute of Parasitic Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2010 Jun 30;28(3):214-7.
To understand the current status of advanced schistosomiasis patients, deliver medical treatment, and improve the case management in Zhejiang Province.
The cases previously diagnosed or suspected as advanced schistosomiasis in the province were the subjects of the investigation. Questionnairing (demographical information, disease history, etc.), clinical examination (ascites syndrome, abdominal palpation), laboratory examination (blood biochemistry, anti-Schistosoma japonicum antibody, eggs), and ultrasonography of the abdomen were used confirming the diagnosis. Treatment was given to the patients.
There were 1 060 advanced schistosomiasis patients in 32 counties of 7 prefectures in the province. Majority of them distributed in water network regions, and lived with poor economic conditions. The average age of the patients was (66.3 +/- 9.3), with 89.3% ranged from 50 to 80 years old. Clinically 71.3% of the cases were with splenomegaly, 27.6% with ascites, 0.9% cases of multiple granuloma in the colon and 0.2% cases with dwarfism. 1 023 patients (96.5%) had received medical treatments. 69.4% of the cases had serious complications with advanced schistosomiasis and 52.5% had concurrently disorders in other systems. 71.1% of the patients had subjective symptoms and 65.2% had hepatosplenomegaly with hepatic fibrosis and dysfunction. The serum positive rate of anti-S. japonicum antibody was 15.7%. Stool hatching test and microscopy revealed no eggs in fecal samples, but 24 out of 38 cases were found metamorphic eggs by rectal biopsy. Three years' medical treatment improved the clinical conditions in 74.3% of the cases.
Situation of the advanced schistosomiasis patients is quite critical. Treatment and care are urgently needed especially for those aged 50 to 80 years old. [
了解浙江省晚期血吸虫病患者现状，开展医疗救治，加强病例管理。
以省内既往诊断或疑似晚期血吸虫病患者为调查对象。采用问卷调查（人口学信息、病史等）、临床检查（腹水征、腹部触诊）、实验室检查（血液生化、抗日本血吸虫抗体、虫卵）及腹部超声检查进行确诊，并给予患者治疗。
全省7个市32个县共有晚期血吸虫病患者1060例。大部分患者分布于水网地区，经济条件较差。患者平均年龄为（66.3±9.3）岁，89.3%的患者年龄在50至80岁之间。临床检查发现，71.3%的患者有脾肿大，27.6%有腹水，0.9%的患者结肠有多发肉芽肿，0.2%的患者有侏儒症。1023例患者（96.5%）接受了治疗。69.4%的患者有晚期血吸虫病严重并发症，52.5%的患者合并其他系统疾病。71.1%的患者有主观症状，65.2%的患者有肝脾肿大伴肝纤维化及肝功能损害。抗日本血吸虫抗体血清阳性率为15.7%。粪便孵化试验和镜检未发现虫卵，但38例患者中有24例经直肠活检发现变性虫卵。经过3年治疗，74.3%的患者临床状况有所改善。
晚期血吸虫病患者情况严峻，尤其对于50至80岁的患者，急需进行治疗和照护。
