摘要
目的 探讨小儿细菌性痢疾 (菌痢 )的新动向 ,研究其防治对策。方法 分析 1 2 4例小儿菌痢的流行菌群、细菌耐药、高敏药物、新型广谱抗菌药物应用以及中毒型痢疾防范 ,并与 80、90年代资料对比分析。结果 2 0 0 2年流行菌群福氏志贺菌占 95 2 %。临床特点 :①发病年龄越来越小 ;②发病不再局限于夏秋季节 ;③小婴儿菌痢常易与婴儿腹泻混淆。环丙沙星临床选用率 5 4 8% ,疗效满意 ,其中小儿毒痢至今仍占 1 8 6 %。结论 证实南昌地区自 80年代至今 ,福氏志贺菌是引起小儿菌痢和毒痢的病原菌。根据药敏 ,选用合理抗菌药物 ,提倡序贯疗法。环丙沙星用于危重患儿 ,静脉制剂剂量不宜过大 [1 0～ 1 5mg/(kg·d) ],疗程不超过 7d。毒痢患儿应及时诊断、早期治疗 。
Objective To explore new trend of bacterial dysentery in children and its prevention and treatment approach.Methods To analysis bacterial resistance and high sensitive medicines according to epidemic bacterial groups of 124 cases bacterial dysentery in children of our hospital. Furthermore,the application of new type wide-spectrum antibiotics and the prevention of poisoning dysentery were analyzed as well. The comparison with prior relative data published in recent two decades were done.Results Sh.Flexneri was predominant pathogen in epidemic bacterial groups in 2002 which accounted for 95.2 % . Clinic findings: ① Age of the disease was becoming younger;② Season of the disease occured not only in summer and autumn;③ Bacterial dysentery in children was always confused with infantile diarrhea. The selecting rate of ciproflioxacin was 54.8 % with good response. Poisoning dysentery in children still accounted for 18 6 % recently.Conclusion The analysis confirmed that Sh.Flexneri was predominant pathogen which caused bacterial dysentery and poisoning dysentery in children since 1980's in Nanchang district. According to local medicine sensitive tests,the reasonable antibiotics were selected and sequential therapy was recommended. Ciprofloxacin was specially used for critical patients,the less . intravenous dosage [10～15 mg/(kg·d)] and lasted no more than 7 days was preferred. Timely diagnosis, early management for poisoning dysentery are the key for reducing mortality.
出处
《小儿急救医学》
2004年第2期93-95,共3页
Pediatric Emergency Medicine
关键词
南昌市
小儿
细菌性痢疾
临床分析
诊断
治疗
Pediatric
Bacterial dysentery
Poisoning dysentery
Sequential therapy
