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本文报告我院从1972年6月至1973年9月初15个月内从64例中分离出78株鼠伤寒沙门氏菌,表明有散发流行。就住院患者47例的资料进行分析,其中小儿33例皆在3岁以内,32例小于2岁,成人14例,大部分病例皆发生于有严重原发病的基础上。临床表现为突然发烧、腹泻,严重者出现脱水、休克、昏迷、抽风。白细胞偏高但分类多正常,肥达氏反应一月内检查对诊断帮助不大,临床上诊断困难,多误诊为痢疾、消化不良等,败血症型及小儿脑膜炎死亡率高。治疗以氯霉素加卡那霉素,氯霉素加氨基苄青霉素,氯霉素加痢特灵为佳,积极支持和中医中药亦有重要作用。最后对传染途径和发病问题以及本组发病特点和治疗问题进行了讨论。
This article reports from our hospital from June 1972 to early September 1973 within 15 months from 64 cases isolated 78 strains of Salmonella typhimurium, indicating the distribution of epidemic. The data of 47 inpatients were analyzed. Among them, 33 cases of infants were within 3 years of age, 32 cases were less than 2 years old and 14 cases were adults. Most of the cases occurred on the basis of severe primary disease. Clinical manifestations of sudden fever, diarrhea, severe dehydration, shock, coma, ventilation. WBC higher but more normal classification, Widal reaction within one month to check the diagnosis is not helpful, clinical diagnosis is difficult, misdiagnosed as dysentery, indigestion, etc., sepsis and high mortality rate of children with meningitis. Treatment with chloramphenicol plus kanamycin, chloramphenicol plus ampicillin, chloramphenicol plus furazolidone is better, and actively support and Chinese medicine also plays an important role. Finally, the route of transmission and the incidence of the disease characteristics and treatment of this group were discussed.