摘要
目的探讨输入性疟疾的临床观察与护理措施。方法对山东省寄生虫病防治研究所2016年5月-2020年10月收治的210例输入性疟疾患者采用镜检疟原虫血涂片进行诊断,观察临床诊治过程中出现的寒战高热、乏力、纳差、肝脾肿大、黄疸、少尿或无尿、精神意识障碍、贫血和血小板减少等体征,比较青蒿素类药物蒿甲醚与青蒿琥酯的治疗效果,并采取多方面综合护理干预及综合预防。结果输入性疟疾患者均有旅居国外生活史及蚊虫叮咬史。患者入院后完善各项检查后采集外周血涂片镜检疟原虫,通过及时调整治疗和护理方案后,疟疾患者得到有效治疗,护理满意度提高,住院期间无堵管、意外拔管、出血、坠床、压疮等并发症发生。1例患者因院外误诊未得到及时治疗而发生脑型疟疾死亡。结论耐心细致地观察,以及规范、个性化的临床路径护理疟疾患者,尽早对输入性疟疾患者作出明确诊断,对降疟疾病死率,取得满意疗效,防止疟疾的播散有重要意义。
Objective To explore the clinical observation of and care for patients with imported malaria.Methods Subjects were 210 patients with imported malaria seen at the Shandong Institute of Parasitic Disease Control and Prevention from May 2016 to October 2020.Patients were diagnosed using blood smears for microscopic detection of Plasmodium,and the appearance of signs such as chills,fever,fatigue,anorexia,hepatosplenomegaly,jaundice,oliguria or anuria,altered consciousness,anemia,and thrombocytopenia was observed during clinical diagnosis and treatment.The efficacy of the artemisinin drugs artemether and artesunate was compared,and a comprehensive approach to care and prevention was taken.Results Patients with imported malaria had a history of living abroad and a history of mosquito bites.After the patient was admitted to the hospital,peripheral blood smears were collected for microscopic detection of malaria parasites.After timely adjustment of the treatment and care plan,patients with malaria were effectively treated,and their level of satisfaction with care increase.During hospitalization,there were no blockages,accidental extubation,bleeding,or complications such as a fall from bed or pressure sores.One patient died of cerebral malaria due to misdiagnosis outside the hospital and not receiving timely treatment.Conclusion Patient and careful observation and standardized and personalized clinical pathways to care for patients with malaria and a prompt definitive diagnosis of imported malaria as soon as possible are crucial to reducing the mortality rate of malaria,achieving satisfactory results,and preventing the spread of malaria.
作者
卜秀芹
马著诗
付婷霞
BU Xiu-qin;MA Zhu-shi;FU Ting-xia(Digestive Diseases Hospital of Shandong First Medical University,Shandong Institute of Parasitic Diseases,Shandong First Medical University&Shandong Academy of Medical Sciences,Jining,Shandong 272033,China;Affiliated Hospital of Jinin,Medical College)
出处
《中国病原生物学杂志》
CSCD
北大核心
2021年第7期826-828,832,共4页
Journal of Pathogen Biology
基金
中国全球基金疟疾项目实施性研究专项(No.201201055)
山东省自然科学基金项目(No.ZR2019PH118,ZR2017YL005)
山东省医药卫生科技发展计划项目(No.2016WS0391,2015WS0265)。
关键词
输入性疟疾
临床观察
护理
预防
impored malaria
clinical observation
nursing
prevention
