Objective To evaluate the effect of the clinical pathway on advanced schistosomiasis patients with acites. Meth?ods According to the Handbook of Schistosomiasis Control and the Clinical Pathway on Advanced Schistosomiasis in Hubei Province the therapeutic effects disease awareness and the satisfaction of patients of 220 advanced schistosomiasis patients ascitic type who were treated by the traditional pathway in 2013 and 220 patients who treated by the clinical pathway in 2014 respectively were evaluated and compared with the statistical method. Results As the outcomes of the patients had no signifi?cant difference between the traditional pathway therapy and the clinical pathway therapy the average hospitalization days and medical expense were reduced when the patients were treated by the clinical pathway. The average hospitalization days were re?duced to 12 days from 14 days. The average medical expense was reduced to RMB 5 800 form RMB 6 400. The average rate of awareness about the disease and the satisfaction rate of the patients were raised to 95% in the patients treated by the clinical pathway. The results of t test for the three indicators above mentioned showed significant differences between the two therapies all P<0.05 . Conclusion The clinical pathway can standardize the medical behavior and avoid the waste of medical resourc?es so as to improve the treatment of advanced schistosomiasis.

Objective To evaluate the efficacy of repeated application of praziquantel in the treatment of hepatic fibrosis due to schistosomiasis. Methods A total of 60 patients with schistosomiasis hepatic fibrosis(clinically diagnosed cases)were selected and divide into a treatment group and control group randomly,with 30 cases each group. The patients in the treatment group were given praziquantel[30 mg/(kg·d)for 2 days]each year for three consecutive years,on the basis of the conventional liver protection therapy and symptomatic treatment. The patients in the control group were given the conventional liver protection therapy and symptomatic treatment. All the treatment duration was 36 months. The clinical symptoms were observed,and the liv-er function,and the levels of HA,LN,IV-C,and PCIII were detected in the two groups before and after the treatment. Re-sults The clinical symptoms and liver function improved,and the HA,LN,IV-C,PCIII levels were decreased in the treat-ment group with varying degrees,and the total effective rate was 93%(26/28). The total effective rate in the control group was 60%(16/27). There was a significant difference between the two groups in the total effective rate(P<0.05). Conclusion The repeated application of praziquantel has a better therapeutic efficacy in the treatment of hepatic fibrosis due to schistosomiasis.

Objective To discuss the clinical characteristics of advanced schistosomiasis combined with tuberculous pleuri?sy,so as to reduce misdiagnosis and mistreatment. Methods The clinical data of 15 patients suffered from advanced schistoso?miasis combined with tuberculous pleurisy were collected and analyzed retrospectively. Results The 15 patients all showed var?ious degrees of gastrointestinal symptoms with the performance of abdominal distension,digestive function and fatigue,14 pa?tients showed various degrees of edematous,9 patients showed stuffiness,4 patients had cough and expectoration,and 2 pa?tients had low fever and night sweats. Three cases were diagnosed within 2 days after admission,9 cases were diagnosed within one week after admission,and 3 cases were diagnosed after one week. Fifteen patients all received anti?tuberculosis treatment based on routine liver protection,diuresis,and symptomatic and supportive treatment. One patient with severe liver and kidney dysfunction died and one with gastrointestinal bleeding died. The remaining 13 patients were clinically cured. Conclusions The patients suffered from advanced schistosomiasis combined with tuberculous pleurisy do not show obvious tuberculosis poison?ing symptoms,and are easily misdiagnosed and missed?diagnosed. Therefore,physicians should pay much attention to the pa?tients whose pleural effusion cannot subside effectively or whose symptom cannot improve.