[Diagnosis and treatment of schistosomiasis japonica-concensuses among ex- perts in Hunan, Hubei and Jiangxi provinces].

In order to further standardize the diagnosis and treatment of schistosomiasis japonica in China, on the basis of evidence-based medicine, the experts on schistosomiasis control from Hunan, Hubei and Jiangxi provinces summarized their consensuses on the disease after the discussion on the current situation and progress of clinical diagnosis and treatment of schistosomiasis in China, with the reference to the Diagnostic Criteria for Schistosomiasis (WS261-2006), which aimed to establish the therapeutic standards or guideline of schistosomiasis in China.

[Multi-disciplinary treatment for advanced schistosomiasis].

OBJECTIVE: To assess the efficiency of multi-disciplinary treatment (MDT) for advanced schistosomiasis. METHODS: A total of 173 advanced schistosomiasis patients who received MDT were selected from January 2010 to December 2011. These patients included 75 splenomegaly cases and 98 ascites cases. Other 193 advanced schistosomiasis patients who received single-discipline treatment (SDT) from January 2007 to December 2009 were also selected, and of them 84 cases were splenomegaly and 109 were ascites. The clinical efficiencies of the two different treatments were analyzed and assessed. RESULTS: Compared to the SDT group, the splenomegaly cases treated by MDT showed a shorter pre-operative preparation time and less days in hospitalization (both P < 0.01), less operation duration, decreased post-operative complications, lower hospitalization costs (all P < 0.05), and less patient complaints (P > 0.05). The ascites cases treated by MDT, compared to the SDT group, had less pre-treatment time, shorter ascites-disappearing time (both P <0.01), and less hospitalization duration, decreased post-treatment complications, lower hospitalization costs and less patient complaints (all P < 0.05). Conclusion MDT has a better efficiency in the treatment of advanced schistosomiasis, and it reduces the operation complications and improves the life quality of the patients.

[Splenectomy and esophagogastric devascularization for advanced schistosomiasis with cavernous transformation of portal vein].

OBJECTIVE: To explore a surgical treatment of advanced schistosomiasis with cavernous transformation of the portal vein. METHOD: The clinical data of 18 patients who suffered from advanced schistosomiasis with cavernous transformation of the portal vein were collected and analyzed retrospectively in the Affiliated Xiangyue Hospital of Hunan Institute of Parasitic Diseases. RESULTS: Two cases were undertaken the endoscopic variceal ligation, and the upper gastrointestinal bleeding happened 32 months and 40 months after the treatment respectively, and they received the splenectomy and esophagogastric devascularization again; 16 cases were undertaken the splenectomy and esophagogastric devascularization. During the follow-up of 6-72 months, no esophageal and gastric varices were found. CONCLUSION: Splenectomy and esophagogastric devascularization is effective in the treatment of advanced schistosomiasis with cavernous transformation of the portal vein.

[Recommendation of a new clinical classification of advanced schistosomiasis].

OBJECTIVE: To recommend a new clinical classification of advanced schistosomiasis for improving the diagnosis and evaluation of therapeutic effect of advanced schistosomiasis. METHODS: The medical records of 11 092 cases of advanced schistosomiasis from the Xiang-Yue Hospital from January 1990 to January 2010 and the medical aid centre for advance schistosomiasis in Hunan Province from January 2004 to January 2010 were collected and classified with the current and new clinical classification methods and the results were statistically analyzed and compared. RESULTS: Based on the current classification method, there were huge splenomegaly (5 710 cases), ascites (2 993 cases), colon proliferative (834 cases), and dwarf (54 cases). However, 1 501 cases were excluded from the current classification. Based on the new classification method, there were 8 types: huge splenomegaly (2 870 cases), ascites (1 885 cases), colon proliferative (425 cases), dwarf (38 cases), universal (1 281 cases), bleeding (1 857 cases), hepatic coma (553 cases), and miscellaneous (1 759 cases). Totally 424 cases were classified into chronic schistosomiasis. CONCLUSION: The new classification method can present a more comprehensive picture for clinical features, severe complications and prognosis of advanced schistosomiasis, and is useful for the diagnosis and treatment of advanced schistosomiasis.

[Discussion on clinical pathways of schistosomiasis].

According to the long-term clinical experience on schistosomiasis control of Hunan Institute of Schistosomiasis and the latest clinical guidelines, this paper makes a discussion on the clinical pathways of 3 types of schistosomiasis, and establishes the pathway management including diagnosis, therapy, hospital stays, and treatment after discharge, nursing, recovery, follow-up and so on, aiming to formulate a standardized flow or a pathway for schistosomiasis treating.