do Espírito-Santo Maria Cristina Carvalho, Magalhães Maíra Reina, Mortari Naíma, de Siqueira França Francisco Oscar, de Albuquerque Luna Expedito José, Gryschek Ronaldo Cesar Borges
Departamento de Molestias Infecciosas e Parasitarias e Laboratorio de Investigacao Medica 6, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Centro Universitario UniFoa, Volta Redonda, Rio de Janeiro, RJ, BR.
Clinics (Sao Paulo). 2018 Sep 21;73:e340. doi: 10.6061/clinics/2017/e340.
Schistosomiasis remains a public health problem. This was a descriptive and retrospective study of 42 patients with a severe form of schistosomiasis who were admitted to the outpatient clinic of the Faculdade de Medicina da Universidade de São Paulo, São Paulo, in São Paulo, Brazil.
A data collection questionnaire was designed from the patient charts, and the following variables were evaluated: age, sex, place of birth, occupation, signs and symptoms of schistosomiasis, data from laboratory and imaging examinations, data regarding treatment outcomes, and the existence of comorbidities. Statistical analysis was carried out using Statistical Package for the Social Sciences 15.0 and Microsoft Excel 2003 software. The significance levels of the tests were fixed, accepting 5% type 1 error (α=0.05). Since this was a retrospective observational study, not all data were available for analysis.
The mean age of the patients was 48.24 years; 57.1% were male. Statistically significant associations were observed between splenomegaly and thrombocytopenia (p=0.004) and between splenomegaly and leukopenia (p=0.046); however, only 4.5% of the patients had esophageal hemorrhage. Some patients received a specific treatment; of those, 42% took praziquantel, and 35.4% took oxamniquine. Nonspecific drug therapy was given as follows: 65% received propranolol, 90% omeprazole, and 43.6% aluminum hydroxide. The other treatments were as follows: 92.9% of patients underwent endoscopic treatment, 85% received sclerotherapy, and 62.5% used elastic bandages.
This preliminary study presents a multidisciplinary outpatient follow-up associated with endoscopic and drug treatments that may be effective at preventing bleeding.
血吸虫病仍然是一个公共卫生问题。这是一项对42例重度血吸虫病患者的描述性回顾性研究，这些患者被收治于巴西圣保罗圣保罗大学医学院门诊。
根据患者病历设计了一份数据收集问卷，并对以下变量进行评估：年龄、性别、出生地、职业、血吸虫病的体征和症状、实验室和影像学检查数据、治疗结果数据以及合并症的存在情况。使用社会科学统计软件包15.0和微软Excel 2003软件进行统计分析。检验的显著性水平固定为接受5%的I型错误（α=0.05）。由于这是一项回顾性观察研究，并非所有数据都可用于分析。
患者的平均年龄为48.24岁；57.1%为男性。观察到脾肿大与血小板减少之间（p=0.004）以及脾肿大与白细胞减少之间（p=0.046）存在统计学显著关联；然而，只有4.5%的患者发生食管出血。一些患者接受了特异性治疗；其中，42%服用吡喹酮，35.4%服用奥沙尼喹。非特异性药物治疗如下：65%接受普萘洛尔，90%接受奥美拉唑，43.6%接受氢氧化铝。其他治疗如下：92.9%的患者接受了内镜治疗，85%接受了硬化疗法，62.5%使用了弹力绷带。
这项初步研究提出了一种与内镜和药物治疗相关的多学科门诊随访，可能对预防出血有效。
