頁籤選單縮合
題名 | 某智能不足兒童教養院內梨形鞭毛蟲病之調查 |
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作者姓名(中文) | 王主科; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 30:2 民78.03-04 |
頁次 | 頁94-99 |
分類號 | 415.291 |
關鍵詞 | 智能不足兒童教養院; 梨形鞭毛蟲病; |
語文 | 中文(Chinese) |
中文摘要 | 1983年著者等在台大醫院小兒科診治一例來自某殘障教養院的智能不足女孩患有梨形鞭毛蟲症合併吸收不良症侯羣。著者等因此前往該院調查梨形鞭毛蟲症流行的情形。我們共檢查239位院童,在同一日採取新鮮糞便,分別裝在貯有polyvingl alcohol及10%福馬林溶液中。前者以Trichrome染色,檢查出48位(20.1%);從者以福馬林乙醚濃縮法檢查出 41位(17.1%)院童糞中有梨形鞭毛蟲囊胞體或滋養體。合併兩種方法有48位(20.1%)院童糞便中有梨形鞭毛蟲。比較兩種方法之檢出率在統計學上沒有差別(P>0.05)。檢查其中42人糞便胰蛋白酶活性值,有38人(90.5%)糞便胰蛋白酶活性值比正常人低,表示感染梨形鞭毛蟲而不治療,多少會有吸收不良的情形。12人接受內視鏡檢查及生檢,共中有 4 人在上消化道肉眼即可見結節性淋巴增生。小腸檢體均有組織學上發炎的變化,其中7人可見淋巴增生(lymphoid hyperplasia)的現象,但僅有7人可在小腸黏膜上看到梨形鞭毛蟲滋養體。患童以metronidazole 250mg每日3回,共治療5天,無明顯的副作用發生。4個月後再度追蹤檢查大便,尚有12人(30%)大便中有梨形鞭毛蟲。這12人可能為治療失敗或再度感染。本研究顯示該教養院收容的智能不足兒童,梨形鞭毛蟲的罹患率很高(20.1%)。對這些感染院童,應及早給予診斷治療並追蹤檢查,並防範再感染。 |
英文摘要 | A 10-year-old mentally retarded girl from an asylum in northern Taiwan was diagnosed to have giardiasis with malabsorption syndrome at the Department of Pediatrics, National Taiwan University Hospital in 1983. A survey for giardiasis in 239 children living in the same asylum was therefore performed. Stool specimens were collected from all children, and giardia was examined simultaneously by formalin-ether concentration method and polyvinyl alcohol preservation followed by Trichrome stain. Forty one cases (17.2%) of giardiasis were detected by the former method while 48 cases (20.1%) by the latter method. Abnormally low stool trypsin activity was found in 38 of the 42 cases (90.5%) tested and the activity returned to normal in 50% of patients after successful treatment. Endoscopic examination and intestinal biopsy of upper gastrointestinal tract were performed in 12 cases. Among them, 4 were found to have nodular lymphoid hyperplasia, lymphoid hyperplasia in 7, and increased mononulear cell infiltration in lamina propria in 7. Forty patients were treated with metronidazole 250mg three times a day for 5 days. Follow-up stool examinations revealed that 12 children (30%) still passed giardia in their stools 4 months after treatment. Reinfection and inadequate sensitivity of the initial screening test may be used to account for such a high rate of treatment failure. |
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