儿童伤寒的早期诊断

目的通过比较肥达反应、血培养、腹部B超在伤寒患儿发病不同阶段诊断的阳性率,探讨儿童伤寒的早期诊断方法。方法对某医院2000年至2007年入院的68例0～14岁伤寒患儿进行回顾性病例分析,利用B超观察发病1、2和3周内患儿肝脏大小、脾脏大小、回肠末段肠壁厚度及回盲部淋巴结的改变,并与相同时间段患儿肥达反应及血培养的阳性率进行比较。结果在发病1、2和3周回肠末段肠壁增厚患儿分别为62例(91.1%)、67例(98.5%)、54例(79.4%);回盲部淋巴结肿大患儿分别为59例(86.7%)、64例(94.1%)、48例(70.5%);肝脏肿大患儿分别为25例(36.7%)、29例(42.6%)、20例(29.4%);脾脏肿大患儿分别为29例(42.6%)、31例(45.6%)、24例(35.3%);肥达反应阳性患儿分别为33例(48.5%)、47例(69.1%)、50例(73.5%);血培养阳性患儿分别是25例(36.7%)、11例(16.1%)、0例(0%)。结论B超检查操作简便、费用低、准确率高,可作为早期诊断儿童伤寒的首选方法。

Early Diagnosis of Typhoid Fever in Children

Objective To evaluate the early diagnosing method of typhoid fever in children. Methods A retrospective study of 68 typhoid fever children patients who was 0-14 years old was performed to evaluate the early diagnosing efficacy of Widal test, Salmonella culture and ultrousound. Abdominal ultrasound, Widal test and Salmonella culture were performed in one week, two week and three week respectively. Results The US findings were as follows： splenomegaly （42.6%, 45.6% and 35.3%）; Bowel wall thickening （91.1%, 98.5% and 79.4%）; mesenteric lymphadenopathy（86.7%, 94.1% and 70.5%）; Widal test： 48.5%, 69.1% and 73.5%; Salmonella culture36.7%, 16.1% and 0%. Conclusion Abdominal ultrasound can be a non-invasive, economical and high sensitive tool for diagnosing typhoid fever.