华支睾吸虫病精品课件

华支睾吸虫病 Clonorchiasis sinensis 概 述 华支睾吸虫病是由华支睾吸虫 寄生在人体肝内胆管所引起的寄生 虫病，因进食未煮熟的淡水鱼虾而 感染。 临床特征为肝肿大、上腹隐痛 、疲乏以及精神不振。 病 原 学 华支睾吸虫生活史 成虫在人体 胆管内产卵 虫卵内含毛蚴 从大便排出 卵被淡水 螺吞食 毛蚴发育成胞蚴 雷蚴以至尾蚴 尾蚴进入鱼 体成囊蚴 人猫狗感染 人猫狗等终宿主 螺鱼第一、 二中间宿主 流行病学 传染源 感染华支睾吸虫的人和哺乳 动物。 传播途径 进食未经煮熟含华支睾吸虫囊 蚴的淡水鱼虾。 人群易感性 普遍易感。 发病机制与病理解剖 发病与否及病变程度取决于成虫寄生在胆 管中的数量。 胆管上皮脱落，腺瘤样增生，胆管壁增厚 ，周围淋巴细胞润和纤维组织增生。 继发性病变 继发性胆管炎、胆囊炎, 胆石症；胆管 上皮增生，虫体堵塞胆管引起胆汁淤滞； 临床表现 潜伏期 12个月 消化道症状 纳差，上腹隐痛与 饱胀，轻度腹泻、肝区隐痛、肝肿 大（左肝明显）； 神经衰弱症状 头晕、失眠、疲 乏、精神不振、心悸、记忆力减退 ； 并 发 症 急、慢性胆囊炎，胆管炎，胆石症 ； 门脉性肝硬化，胆汁性肝硬化； 胰腺炎； 原发性肝细胞癌、胆管上皮癌； 诊断与鉴别诊断 诊断依据 1、流行病学资料 2、临床表现 3、实验室检查 虫卵检查 大便查虫卵，集卵法， 十二指肠引流液查虫卵。 血象 EC增多。 血清学 ELISA检测特异性抗体。 鉴别诊断 病毒性肝炎 其他原因所致肝硬化 原发性肝癌 肝片虫吸虫病 其他 治 疗 病原治疗 吡喹酮 1525mg/kg,tid 2d (总剂量90150mg/kg) 。 阿苯达唑 对症与支持治疗 预 防 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