埃及血吸虫病误诊为膀胱肿瘤两例报道并文献复习

发布时间：2018-05-01 09:22

本文选题：埃及血吸虫病 + 膀胱肿瘤　；参考：《中国全科医学》2017年08期

【摘要】：目的探讨埃及血吸虫病的流行病学、临床特征及治疗方法,避免误诊。方法回顾性分析浙江省台州医院2016年5月收治的2例埃及血吸虫病患者的临床资料,并复习相关文献。结果患者1,男,53岁,因劳务输出至非洲尼日利亚工作,2016年4月回国。主诉间歇性无痛性终末血尿1年。查体无特殊。泌尿系CT检查:右侧输尿管及右肾积水,膀胱壁增厚,考虑膀胱肿瘤。B超示:膀胱壁增厚。血常规示:嗜酸粒细胞计数升高,嗜酸粒细胞分数明显升高。行膀胱镜检查+活检术,考虑尿路上皮增生伴亚急性炎及寄生虫卵(血吸虫卵首先考虑);尿沉渣镜检确诊后放置输尿管D-J管。患者2,男,52岁,与患者1同期去非洲工作,同期回国。主诉:无痛性间歇性血尿1个月。查体无特殊,B超、泌尿系CT均表现为膀胱壁增厚,未见肾积水。行膀胱镜检查+活检术,考虑嗜酸性膀胱炎,未见虫卵;尿沉渣镜检确诊。2例患者尿中均发现有尾刺的虫卵确诊,口服吡喹酮1个疗程,1周后复查尿沉渣镜检,均未见虫卵。结论在诊治有血尿症状的援非归国人员时,应结合流行病学资料,避免误诊,结合吡喹酮抗血吸虫药物化疗,一般预后良好。
[Abstract]:Objective to investigate the epidemiology, clinical features and treatment of schistosomiasis in order to avoid misdiagnosis. Methods the clinical data of 2 cases of schistosomiasis in Taizhou Hospital of Zhejiang Province in May 2016 were analyzed retrospectively. Results patient 1, male, 53 years old, returned to Nigeria in April 2016 because of labor export to work in Nigeria. The main complaint was intermittent painless terminal hematuria for 1 year. There is no special examination. Urinary system CT examination: right ureter and right kidney hydronephrosis, bladder wall thickening, considering bladder tumor. B ultrasound: bladder wall thickening. Blood routine showed that eosinophil count increased and eosinophil fraction increased significantly. Cystoscopy was performed to consider ureteral epithelial hyperplasia with subacute inflammation and parasite eggs (Schistosoma japonicum eggs were first considered) and ureteral D-J tube was placed after ureteroscopy. Patient 2, male, 52 years old, and patient 1 at the same time to work in Africa, at the same time return home. Main complaint: painless intermittent hematuria for 1 month. There was no special examination, B-ultrasonography and urological CT showed thickening of bladder wall and no hydronephrosis. Cystoscopy was performed, and no egg was found in eosinophilic cystitis, but no eggs were found in the urine of 2 patients diagnosed by urinary sediment examination, and no eggs were found in urine after a course of one course of oral praziquantel. Conclusion in the diagnosis and treatment of non-returnees with hematuria symptoms, we should combine epidemiological data, avoid misdiagnosis, and combine praziquantel anti-schistosomiasis drug chemotherapy, the general prognosis is good.
【作者单位】：浙江省台州医院泌尿外科;浙江省台州医院病理科;浙江省台州医院检验科;
【分类号】：R532.21

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