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自应用氯霉素治疗伤寒病人以来,病死率已低于2%,但在亚、非地区,病死率仍为12～32%。适当的抗生素与标准的支持疗法仍不能防止许多危重病人的死亡。作者采用随机双盲法对危重伤寒病人进行大剂量地塞米松结合抗生素和支持疗法的研究。自1981年4月15日～1982年7月15日收入雅加达传染病医院的伤寒杆菌或副伤寒甲培养阳性的病人共263例,对其中有意识障碍或休克的42例年龄5～54岁的病人(除外孕妇及伴肠穿孔患者)进行随机双盲法对照研究。最后因3例在6小时内死亡,1例仅肛拭培养伤寒杆菌阳性除外,其余38例中地塞米松组20例,安慰剂组18例。全组均接受氯霉素治疗,剂量为
Since the application of chloramphenicol in the treatment of typhoid fever patients, the case fatality rate has been less than 2%, but in Asia and Africa, the case fatality rate is still 12 to 32%. Appropriate antibiotics and standard supportive therapies still can not prevent the death of many critically ill patients. The authors used randomized, double-blind, high-dose dexamethasone-containing antibiotics and supportive care for patients with critically ill typhoid fever. A total of 263 cases of typhoid fever or paratyphoid fever positive patients who were admitted to Jakarta Infectious Disease Hospital from April 15, 1981 to July 15, 1982 were recruited. A total of 42 patients aged 5 to 54 years with impaired consciousness or shock (Except pregnant women and patients with intestinal perforation) were randomized double-blind control study. Finally, 3 patients died within 6 hours, except 1 case of anal swab culture typhimurium positive except for the remaining 38 cases dexamethasone group 20 cases and placebo group 18 cases. The whole group received chloramphenicol treatment, the dose was