小儿中毒型细菌性痢疾33例分析

本文对我院1995年1月～1996年12月33例毒痢进行分析，其中脑型20例，混合型12例，休克型1例。便培养阳性率78．7％均为福氏志贺菌，临床表现有高热、呕吐、脓血便、抽搐，电解质紊乱及多脏器功能衰竭等，治疗采用先锋必，丁胺卡那，部分加服氟哌酸或利福平及抗休克应用东莨菪碱同时配用多巴胺取得较好疗效，本组治愈率为81．8％，病死率3．3％。早期便培养以明确病原并选用敏感抗生素是至关重要的。

CLINICAL ANALYSIS ON 33 CASES OF PEDIATRIC TOXIC BACILLARY DYSENTARY

From January 1995 to December 1996,33 children with toxic bacillary dysentary were treated at our hospital. Of the 33 cases, toxic cerebropathy occurred in 20 patients,toxic cerebropathy with shock in 12 patients, andshock in 1 patient. The Sh. flexneri and the Sh. dysenteriae were found in stool culture of the most patients (78. 7%).The clinical manifestation included fever,vomitting ,pus and blood stool,convulsion,disturbance of fluid and electrolyte, and multiorgan failure. We managed those patients with antibioics such as Cefobid and Amikacini.In addtiion,some patients were asked to take the medicines such as Tab.Norfloxacin or Rifumpinum at the same time.Some pa tients with shock were given Scopolamine and Dopamine as an adjuvant treatment.The results were good.The cure rate was 81. 8%. The maltality rate was 3. 03%. In conclusion, the authors considered that the results of early stool cultureplay an important role in the diagnosis and treatment of toxic bacillary dysentary.In addition,the proper use of Dopamine and selecting antibiotics based on the results of stool cultrue is a key to the satifactory prognosis .