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通过文献复习以及作者的工作实践,对四川省黑热病患者临床资料进行回顾性分析,探讨犬源性黑热病的临床特点、诊断方法,并介绍了国内在这些方面的经验和体会,以供临床诊断和防治利什曼病的参考,提高本病的诊断率,减少误诊。黑热病均为白蛉季节有疫区居住史的患者,临床特点为反复不规则发热、脾肿大或肝脾均肿大、全血细胞减少及血浆球蛋白增高。易误诊为肝硬化、再生障碍性贫血、白血病、伤寒和结核病等。非疫区医疗机构未能结合流行病学史、尽早做病原学或免疫学检查是误诊主要原因。对来自疫区的患者应加强对本病的防范意识和提高诊断水平,掌握黑热病的流行病学资料、临床特点,尽早作病原学检查或血清学检测是避免误诊的关键。
Through reviewing the literature and the author’s work practice, the clinical data of patients with kala-azar in Sichuan Province were retrospectively analyzed to explore the clinical features and diagnosis methods of canine-derived kala-azar and to introduce the domestic experience and experience in these areas for clinical diagnosis and Prevention and treatment of leishmaniasis reference to improve the diagnosis rate of the disease and reduce misdiagnosis. The kala-azar are patients with epidemic history of whitefly season, the clinical features of repeated irregular fever, splenomegaly or liver and spleen are swollen, pancytopenia and plasma globulin increased. Easily misdiagnosed as cirrhosis, aplastic anemia, leukemia, typhoid and tuberculosis. Pest free areas of medical institutions failed to combine the history of epidemiology, as early as possible etiology or immunological examination is the main reason for misdiagnosis. Patients from the epidemic area should strengthen the prevention awareness of the disease and improve the level of diagnosis, grasp the epidemiological data of kala-azar, clinical features, as early as possible etiological examination or serological test is to avoid misdiagnosis of the key.