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患儿,女,4岁。因高热伴血便12天于1982年8月31日入院。患儿12天来持续高热,频繁腹泻,初起为黄色稀便,继而为脓血便,每日10余次。无呕吐及抽搐。当地卫生室予庆大霉素治疗2天,仍高热,腹泻增至每日数十次,为果酱样,奇臭。病后第二天到乡卫生院就诊,拟“急性菌痢”予卡那霉素、氯霉素等,使用激素、补液等治疗6天无效,且又解血水样大便,即转地区医院拟“中毒性菌痢”治疗3天仍无效转本院。患儿平素无慢性腹泻史,发病前后住处周围无腹泻流行。体检:T38.9℃,P156次/分,R44时/分,Bp92/50mmHg。精神萎靡,重病面容,贫血貌,无黄疸。周身皮肤、粘膜无出血点及瘀斑,无紫纹。浅表淋巴结不肿大。颈部无抵抗。心肺无异常。肝肋下1.5cm,质较,脾肋下
Children, female, 4 years old. Due to fever with blood will be 12 days in August 31, 1982 admission. Children with persistent high fever for 12 days, frequent diarrhea, initially yellow loose stools, followed by pus and blood will be more than 10 times a day. No vomiting and convulsions. Local health room to gentamicin treatment for 2 days, still high fever, diarrhea increased to dozens of times a day, for the jam-like, stinky. The day after the illness to the township hospitals for treatment, to be “acute bacillary dysentery” to kanamycin, chloramphenicol, etc., the use of hormones, rehydration and other 6 days treatment is invalid, and heal the watery stool, turn to the District Hospital The proposed “toxic bacillary dysentery,” 3 days is still invalid transfer to the hospital. Children usually have no history of chronic diarrhea, before and after the onset of dilapidation around the accommodation popular. Physical examination: T38.9 ℃, P156 times / min, R44 / min, Bp92 / 50mmHg. Apathetic, serious face, anemia, no jaundice. Whole body skin, mucous membrane without bleeding spots and ecchymosis, no purple pattern. Superficial lymph nodes are not enlarged. Neck no resistance. No abnormal heart and lung. Liver ribs 1.5cm, quality, spleen ribs