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目的探讨小儿伤寒误诊的原因,减少误诊率。方法收集1995年1月~2010年月6月收治住院确诊的93例小儿伤寒病例中,初诊误为其他病种的患儿60例进行分析。结果 93例小儿伤寒中误诊为非伤寒者60例,误诊率为64.5%,以误诊上呼吸道感染最多(29例),肺炎(9例),支气管炎、菌痢、败血症(4~5例),病毒性心肌炎、病毒性肝炎、贫血原因待查、肺结核、传染性单核细胞增多症和川崎病(1~2例)。结论详细收集病史,仔细体检,动态观察体征的变化,常规计数嗜酸性粒细胞和肥达反应,及时做血培养及粪培养等实验室检查是减少误诊、漏诊的关键。
Objective To investigate the causes of misdiagnosis of pediatric typhoid fever and reduce the rate of misdiagnosis. Methods A total of 93 cases of pediatric typhoid fever diagnosed in hospital from January 1995 to June 2010 were collected and 60 cases were newly diagnosed as children with other diseases. Results A total of 93 cases of typhoid fever were diagnosed as non-typhoid fever in 60 infants, with a misdiagnosis rate of 64.5%. Among them, 29 were diagnosed as upper respiratory tract infection, 9 were pneumonia, 4 were bronchitis, bacillary dysentery and sepsis (4-5 cases) , Viral myocarditis, viral hepatitis, causes of anemia to be investigated, tuberculosis, infectious mononucleosis and Kawasaki disease (1-2 cases). Conclusion It is the key to reduce the misdiagnosis and misdiagnosis that the detailed collection of medical history, careful physical examinations, dynamic observation of signs and signs, routine counting of eosinophils and fatal response, and prompt laboratory tests such as blood culture and excrement culture.