中国麻风皮肤病杂志 ›› 2023, Vol. 39 ›› Issue (10): 731-736.doi: 10.12144/zgmfskin202310731

• 临床研究 • 上一篇    下一篇

综合性医院14例麻风诊治回顾分析

许经纶,许功军,兰燕琴,解凡,赵文军,刘冬梅   

  1. 金华市第五医院，浙江金华，321000
  • 出版日期:2023-10-15 发布日期:2023-10-11

Retrospective analysis of 14 cases of leprosy diagnosis and treatment in comprehensive hospitals

XU Jinglun, XU Gongjun, LAN Yanqin, XIE Fan, ZHAO Wenjun, LIU Dongmei   

  1. Jinhua Fifth Hospital, Jinhua 321000, China
  • Online:2023-10-15 Published:2023-10-11

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摘要： 目的：整理分析医院麻风病例信息，总结经验，减少麻风误诊。方法：回顾分析近10年我科收治的麻风病例临床与病理信息。结果：近10年共收治14例麻风患者，其中13例为外来务工人员。无麻木感者7例，以瘙痒感就医者2例，足下垂1例，多误诊为湿疹。14例患者均行HLA-B*1301筛查，阳性2例。14例患者中发生I型麻风反应3例，II型麻风反应2例，混合型麻风反应1例。病理表现为真皮内均有以泡沫细胞及组织细胞为主的炎细胞浸润，抗酸染色阳性，部分可见菌团。结论：临床中要提高麻风诊治意识，治疗前要进行HLA-B*1301等位基因排查，治疗过程中要注意及时发现麻风反应，避免畸残的发生。

关键词: 麻风, 临床, 病理, 回顾分析

Abstract: Objective: To summarize the data of leprosy cases in our hospital in order to reduce the misdiagnosis of leprosy. Methods: The data of clinical and pathological information of leprosy cases admitted to our department in the past 10 years were analyzed. Results: In the past 10 years, a total of 14 cases of leprosy were treated, of which 13 were migrant-workers. There were 7 cases without numbness, 2 cases with itching, and 1 case with foot drop. They were often misdiagnosed as eczema. All the 14 patients underwent HLA-B*1301 screening, and two cases were HLA-B*1301 carriers. Of 14 patients, 3 had type I leprosy reaction, 2 had type II leprosy reaction, and 1 had mixed leprosy reaction. The pathological examination showed the infiltration of foam cells and histiocyte in the dermis, acid fast staining was positive, and some bacterial colonies were visible. Conclusions: It is necessary to improve the awareness of diagnosis and treatment of leprosy in the clinic, to screen HLA-B*1301 allele before treatment, and pay attention to the timely detection of leprosy reaction during treatment to avoid the occurrence of teratogenic disability.

Key words: leprosy, clinic, pathology, retrospective analysis