Kjetland E F, Poggensee G, Helling-Giese G, Richter J, Sjaastad A, Chitsulo L, Kumwenda N, Gundersen S G, Krantz I, Feldmeier H
Ullevaal Centre for International Medicine, Research Forum, Oslo, Norway.
Acta Trop. 1996 Dec 30;62(4):239-55. doi: 10.1016/s0001-706x(96)00026-5.
A total of 51 women with urinary schistosomiasis haematobium were examined in order to identify diagnostic indicators for female genital schistosomiasis (FGS). Patients were selected at random from the outpatient department of the Mangochi District Hospital, Malawi. The medical histories were recorded according to a pre-designed questionnaire and the women were subjected to a thorough gynaecological examination including colposcopy and photographic documentation of lesions. Microscopy of genital biopsies revealed that 33 of the 51 women had S. haematobium ova in cervix, vagina and/or vulva in addition to the presence of ova in urine. The most sensitive diagnostic procedure was beside microscopic examination of a wet cervix biopsy crushed between two glass slides, which revealed 25 of the 33 genital infections. There was a significant correlation between the size of genital lesions and the number of ova counted per mm2 of crushed tissue. Women with FGS had significantly more tumours in the vulva than women with schistosomiasis limited to the urinary tract. Most of the observed genital pathology could easily be identified by the naked eye, but colposcopic examination yielded valuable additional information like the demonstration of neovascularisation around cervical sandy patches. Few of the symptoms previously regarded as indicators for FGS could be linked to the presence of schistosome ova in genital tissue. Husbands of infertile women with FGS had children with other women significantly more often than husbands of women who only had urinary schistosomiasis. This, together with the finding that the majority of the divorced women had FGS, indicates that the manifestation of this disease may have implications for the marital and sexual life of the affected women.
共有51名埃及血吸虫病女性患者接受了检查，以确定女性生殖器血吸虫病（FGS）的诊断指标。患者从马拉维曼戈奇地区医院门诊部随机选取。根据预先设计的问卷记录病史，并对这些女性进行全面的妇科检查，包括阴道镜检查和病变的摄影记录。生殖器活检显微镜检查显示，51名女性中有33名除尿液中存在虫卵外，宫颈、阴道和/或外阴也有埃及血吸虫卵。最敏感的诊断方法是在两片载玻片之间挤压湿宫颈活检组织进行显微镜检查，该方法在33例生殖器感染中发现了25例。生殖器病变大小与每平方毫米挤压组织中虫卵计数之间存在显著相关性。患有FGS的女性外阴肿瘤明显多于仅患有泌尿系统血吸虫病的女性。大多数观察到的生殖器病理变化肉眼即可轻松识别，但阴道镜检查提供了有价值的额外信息，如宫颈沙粒样病变周围新生血管的显示。以前被视为FGS指标的症状中，很少能与生殖器组织中血吸虫卵的存在联系起来。患有FGS的不育女性的丈夫与其他女性生育孩子的情况明显多于仅患有泌尿系统血吸虫病女性的丈夫。这一点，再加上大多数离婚女性患有FGS这一发现，表明这种疾病的表现可能会对受影响女性的婚姻和性生活产生影响。
