非洲黑人伤寒并发肠穿孔258例治疗体会

目的：针对非洲极其简陋医疗条件，探讨提高当地黑人伤寒合并肠穿孔的治疗效果。方法：对258例伤寒并肠穿孔病人的病因、处理原则、手术方法、预后、存在问题及解决办法进行总结，205例作单纯肠修补术，53例作部分回肠切除，其中47例作回肠造瘘术，6例作回肠端端吻合术。结果：225例治愈，死亡33例，其中并发切口感染153例；再穿孔1例；再穿孔病人二次手术后治愈，153例切口感染者，125例经引流及伤口换药后治愈，28例经二期缝合治愈。结论：尽早手术是治疗伤寒并肠穿孔成功的关键；改善生活环境及生活习惯是减少伤寒发病，改善医疗条件，早期诊断及治疗，提高医务人员素质及有效的抗感染治疗是减少术后并发症的有力措施。

论《伤寒论》中苦寒药的运用特点

张仲景不仅擅用温热药 ,对苦寒药的运用也十分灵活 ,为后世温病学的发展奠定了基础。本文从清热泻火、解毒止利、攻下逐水、利湿退黄、清热祛瘀、清热养阴、寒热并用等七个方面总结了仲景在《伤寒论》

副伤寒132例临床特点分析

目的:分析副伤寒的临床特点。方法:对132例确诊的副伤寒进行回顾性分析。结果:(1)以甲型副伤寒为多发;(2)本病具有起病急,临床症状不典型,并发症以肝肾损害为主的特点;(3)传统的诊断指标如:相对缓脉、玫瑰疹及肥达氏反应阳性的出现率低,而WBC正常和升高现象却占总病例的80%以上,但嗜酸细胞计数及血、骨髓培养仍是主要诊断依据;(4)传统的氟霉素耐药率高,而氟喹诺酮类也面临着耐药的倾向。结论:联合用药可提高疗效。值得临床医生注意。根据临床特点,准确诊断。

恙虫病50例分析

目的：总结诊疗恙虫病的体会，以免误诊误治。方法：回顾性分析2002—05／2007—10我院收治的50例恙虫病资料。结果：均有持续性发热，可出现肺、心、肝、肾等多器官损害，特征性的焦痂或溃疡发生率为66％．外斐氏反应多数大于1：160（多出现在病程7～10d后）。氯霉素治疗多数效果良好。结论：恙虫病临床表现多种多样，容易误诊和漏诊，必要时予诊断性治疗，以免错过治疗时机。治疗首选氯霉素、多西环素及阿奇霉素可用于特殊患者的治疗。

Pancreatic abscess following scrub typhus associated with multiorgan failure

Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years old man with acute pancreatitis with abscess formation and multiorgan failure. Abdominal computed tomography showed multiple infected pancreatic pseudocysts with periopancreatic infiltration. Multiorgan failure was successfully treated with doxycycline, ceftriaxone, and supportive management. The pancreatic abscess was successfully drained percutaneously and the sizes of pseudocysts decreased remarkably.

Antimicrobial Activity of Probiotics on Swiss Mice

Salmonella enterica serovar typhimurium is the first cause identified of food poisoning in humans; new data indicate that the resistant strains of Salmonella sp. can be inhibited by a bacterial population present in foods have been called probiotics. Our study was conducted on Swiss albino mice in order to know the effect of probiotics or biotherapeutic agents, and suggest the different therapeutic possibilities of intestinal complications related to the presence of Salmonella enterica serovar typhimurium; Reference strains, Lactobacillus delbrueckii subsp, bulgaricus, Lactobacillus acidophilus and Lactobacillus paracasei in combination with Bifidobacterium sp. were tested for their health benefits. The number of Salmonella enterica serovar typhimurium decreases in intestine, in the stomach and in the liver for group 2, 3 in case of preventive treatment and group 4, 5 in case of a therapeutic treatment due to the use of a cuRure of probiotics, in comparison with group 1 where we recorded a high number. The bio-therapeutic treatment was finally confirmed by macroscopic and microscopic observations of different target organs before and after treatment for the experiment period.

尼日尔国家伤寒236例诊疗分析

目的加深了解掌握伤寒的诊断及治疗。方法回顾性总结分析236例伤寒的诊疗资料。结果 236例中治愈率37%,好转率51.3%,病死率5.5%,转外科治疗6.2%。结论熟练掌握伤寒临床表现,早期诊断,及时使用有效抑菌和杀菌药物,彻底治疗,是提高伤寒治愈率及降低病死率的重要措施。

甲型副伤寒214例临床分析

为探讨甲型副伤寒的早期诊断和合理治疗。对214例经细菌学和血清学确诊的甲型副伤寒患者的资料进行回顾性分析。结果表明原因不明发热3 d以上,而血常规白细胞正常或减少,特别是嗜酸性粒细胞减少或消失,结合右下腹压痛、肝脾肿大、玫瑰疹、相对缓脉等,1周内采血检测特异性IgM抗体有利早期诊断。第三代头孢菌素、喹诺酮类及氯霉素疗效满意。

急诊恙虫病46例分析

目的探讨恙虫病的诊治方法。方法对到云南普洱市人民医院急诊的恙虫病46例患者的资料进行分析。结果 46例均有发热,起病急骤在1d内达高峰者20例;起病稍缓27d为26例,体温多在39～40℃,典型特征表现为皮肤有焦病或溃疡,局部或全身淋巴结肿大,皮疹其临床表现最易误诊为急性上呼吸道感染、肺炎、伤寒等常见病。结论对急诊发热患者应详细询问病史、详细体检、尤其注意皮肤隐蔽、潮湿部位有无焦病或溃疡、淋巴结肿大和皮疹。