儿童中毒型细菌性痢疾脑型的诊断及治疗

目的了解儿童中毒型细菌性痢疾（简称毒痢）的病原学特点，探讨毒痢脑型的诊断及治疗。方法对我院１９９７年收治的儿童毒痢进行临床分型及资料分析，复习有关文献。结果５２例毒痢中脑型３３例，休克型３例，混合型１６例。有脑水肿表现者（包括脑型及混合型）４９例，占总数的９４２％。均以发热、惊厥、腹泻发病，惊厥在发热后１～２３小时出现，腹泻在发热后１～１７小时出现。便培养阳性率４４９％，均为福氏２ａ型。结论对福氏２ａ型痢疾杆菌的流行趋势和耐药应继续监测；对毒痢脑水肿的抢救必须分秒必争，早期诊断及治疗是降低病死率、改善预后的关键

Diagnosis and treatment of cerebral-type toxic bacillary dysentery in children

Objective To study the etiology characteristics of toxic bacillary dysentery (TBD) and investigate the diagnosis and treatment of cerebral-type TBD in childern.Methods Clinical classification and data analysis were done in children with TBD hospitalized in 1997.Reviewing literature of TBD.Results Of 52 children with TBD,there were 33 cases of cerebral-type,3 cases of shock-type and 16 cases of mixed-type TBD.49 patients with findings of brain edema (including cerebral-type and mixed-type TBD) occupied 94.2% of those with TBD.All of them were characterized by fever,seizure and diarrhea.Seizure occurred in l to 23 hours later than fever,and diarrhea occurred in l to 17 hours than fever.The positive rate of stool culture was 44.9%,and the pathogen were all S.flexneri,type 2a.Conclusions The study for the epidemiological trend and resistence to antibiotics of S.flexneri,type 2a,should be kept go on .Management to the brain edema in patients with TBD should be in time and earlier.Earlier diagnosis and treatment is the key of the decrease of mortality and improvement of prognosis.