Banu Tahmina, Chowdhury Tanvir K, Kabir Mahfuzul, Bhuiyan Md Akbar H, Laila Kamrun, Kabir Nurul, Hannan Md Jafrul, Hoque Momtazul, Mazumder Subash
Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh.
Eur J Pediatr Surg. 2012 Aug;22(4):311-4. doi: 10.1055/s-0032-1315811. Epub 2012 Jul 10.
The purpose of this study is to describe the experience of managing leech infestation in lower urinary tract from a tropical country.
Medical records (January 2002 to December 2010) of children with history of leech infestation in the urinary system, admitted in the Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong, Bangladesh were reviewed. All patients underwent saline irrigation through urethral catheter. When saline irrigation failed, cystoscopic examination was done with removal of leeches by flexible graspers. Follow-up was done 2 weeks later.
The study included 117 patients. Age ranged from 4 to 12 years. Male and female ratio was 3.7:1. All patients had per urethral bleeding. 51 (43.6%) patients had suprapubic pain. All children underwent saline irrigation through urethral catheter. Spontaneous expulsion occurred after saline irrigation in 57 (48.7%) patients. The expelled leeches were alive in 11 cases; dead in 46 patients. Cystoscopic removal of leeches was done in 60 patients (51.3%). In the cystoscopic group, 54 of the removed leeches were dead and 6 were alive.
Cystoscopic removal can be a useful technique for the removal of leeches from the urinary tract when saline irrigation fails.
本研究的目的是描述一个热带国家处理下尿路水蛭寄生的经验。
回顾了2002年1月至2010年12月在孟加拉国吉大港吉大港医学院医院小儿外科住院的有泌尿系统水蛭寄生史儿童的病历。所有患者均通过尿道导管进行盐水冲洗。当盐水冲洗失败时，进行膀胱镜检查并用柔性抓钳取出水蛭。2周后进行随访。
该研究纳入了117例患者。年龄范围为4至12岁。男女比例为3.7:1。所有患者均有尿道出血。51例（43.6%）患者有耻骨上疼痛。所有儿童均通过尿道导管进行盐水冲洗。57例（48.7%）患者在盐水冲洗后水蛭自行排出。排出的水蛭中，11例存活；46例死亡。60例患者（51.3%）进行了膀胱镜下取水蛭。在膀胱镜检查组中，取出的水蛭54例死亡，6例存活。
当盐水冲洗失败时，膀胱镜下取水蛭可能是一种从尿路中取出水蛭的有用技术。
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