【摘要】 对湘西自治州人民医院自1992年1月至2002年12月收治的432例伤寒儿童病例临床资料进行分析,结果显示:所有儿童均发热,伴消化道症状者198例(45.83%),肝脏肿大者345例(79.86%),脾脏肿大者86例(19.90%);256例患儿出现并发症,并发肺炎129例(29.86%),伤寒肝炎64例(14.8%),心肌炎52例(12.04%),肠出血、肠穿孔很少见;白细胞在正常范围者302例(69.91%),嗜酸性粒细胞绝对计数为0者345例(79.86%).药敏报告表明伤寒杆菌对氯霉素的耐药性明显下降,对氨基糖苷类抗生素几乎不耐药,而氨苄青霉素尤其是复方新诺明耐药较多,几乎所有菌株对第3代头孢菌素、喹诺酮类敏感.结论:伤寒病6岁以上学龄儿童为主要患病人群,临床表现不典型且复杂,嗜酸性粒细胞为0仍是儿童伤寒的1个特点,治疗儿童伤寒以第3代头孢菌素疗效好.更多还原

【Abstract】 Objective:To understand the features of children’s typhoid fever in the minority nationality region in Western Hunan.432 Methods:hospitalized children identified as typhoid fever were analyzed retrospectively.Results:All patients had fever and most of them were complicated with gastrointestinal tract symptoms.345 (79.86%) cases had hepatomegaly of which 86(19.90%) had splenomegaly,256 patients had complications including bronchitis-pneumonia (29.86%) hepatitis (14.8%) myocarditis (12.04%) and others.But rectal bleeding and intestinal perforation were seldom observed.White blood cell accounts were normal in (69.91%) children.Eosinophil accounts were decreased to zero in the major patients (79.86%).Antibiotics sensitive tests revealed that aminoglycosides,the third generation cephalosporins and Huroquinolones drags were sensitive to salmonella typhi chloramphenicol resistance to salmonella typhi decreased.Ampicillin and Compound Sulfamethoxazole resistance were common.Conclusions:Typhoid fever is present all year round but more prevalent in summer,and usually affects Children over 6 years of age.The clinical characteristics are atypical and complex.Zero of eosinophil accounts is still a major clue for typhoid fever.The third generation cephalosporins antibiotics show good effectivity in the treatment of children’s typhoid fever.更多还原