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急性血性腹泻与水样腹泻的比较:一项病例对照研究。

Comparison of acute bloody and watery diarrhea: a case control study.

作者信息

Kuşkonmaz Bariş, Yurdakök Kadriye, Yalçin S Songül, Ozmert Elif

机构信息

Department of Pediatrics, Social Pediatrics Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Turk J Pediatr. 2009 Mar-Apr;51(2):133-40.

Abstract

The clinical and laboratory findings of 290 cases of bloody diarrhea who presented to the department of Diarrhea Training and Treatment between June 1998 and May 2002 were investigated, and compared to those of two consecutive cases who had watery diarrhea. The bloody diarrhea group had higher mean age, higher frequencies of diarrhea, lower frequencies of vomiting, and shorter durations of diarrhea at the time of admission as compared to the watery diarrhea group. The number of cases using antibiotics before the onset of diarrheal attacks was higher in the bloody diarrhea group, and sulbactam-ampicillin had been used more frequently in this group. The presence of dehydration was similar in the two groups, but the occurrence of moderate to severe dehydration was significantly less in the bloody diarrhea group. Salmonella was the most common enteropathogen in the bloody diarrhea group; however, isolation of shigella was similar in both groups. In the bloody diarrhea group, one had convulsion, one rectal prolapse, and one intussusception. The rates of hospitalization and antibiotic use were higher in the bloody diarrhea group. The use of antibiotics should be evaluated in cases with bloody diarrhea. Further studies are necessary to detect changes in the pathogens responsible for bloody diarrhea in developing and developed countries.

摘要

对1998年6月至2002年5月间到腹泻培训与治疗科就诊的290例血性腹泻患者的临床和实验室检查结果进行了调查,并与连续两例水样腹泻患者的结果进行了比较。与水样腹泻组相比,血性腹泻组患者的平均年龄更高,腹泻频率更高,呕吐频率更低,入院时腹泻持续时间更短。血性腹泻组在腹泻发作前使用抗生素的病例数更多,且该组更频繁地使用了舒巴坦-氨苄西林。两组脱水情况相似,但血性腹泻组中重度脱水的发生率明显更低。沙门氏菌是血性腹泻组最常见的肠道病原体;然而,两组志贺氏菌的分离情况相似。在血性腹泻组中,有1例发生惊厥,1例直肠脱垂,1例肠套叠。血性腹泻组的住院率和抗生素使用率更高。对于血性腹泻病例,应评估抗生素的使用情况。有必要进一步开展研究,以检测发展中国家和发达国家血性腹泻病原体的变化。

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