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118例儿童急性腹泻的肠道感染、牛奶不耐受及肠道外感染

Enteric infections, cow's milk intolerance and parenteral infections in 118 consecutive cases of acute diarrhoea in children.

作者信息

Capano G, Guandalini S, Guarino A, Caprioli A, Falbo V, Giraldi V, Ruggeri F M, Vairano P, Vegnente A, Vairo U

出版信息

Eur J Pediatr. 1984 Sep;142(4):281-5. doi: 10.1007/BF00540253.

Abstract

One hundred and eighteen consecutive cases of childhood acute diarrhoea (mean age: 10.5 months) were studied after admission to our Pediatric Unit in Naples over a 13-month period. A diagnosis was established in 92 patients (78%): 55% of patients were found to have an infectious enteritis (among them, 5 had ETEC infections and 1 had an ST-producing Klebsiella infection), 12% a parenteral infection, 11% cow's milk intolerance. The occurrence of gross blood (P less than 0.01), leukocytes, and reducing substances in the stools was more commonly associated with infectious enteritis than with diarrhoea due to all other causes. In 14 patients (8 of whom were malnourished), diarrhoea ran a prolonged course. In all, the eventual outcome was favourable. Our findings, while confirming that infectious enteritides account for most of acute diarrhoeas in children, stress the importance of parenteral infections and cow's milk intolerance in this condition. Also, the need for an accurate search for enterotoxigenicity of enterobacteria before ruling out their pathogenetic role is stressed.

摘要

在那不勒斯的我们的儿科病房,对13个月期间收治的118例连续性儿童急性腹泻病例(平均年龄:10.5个月)进行了研究。92例患者(78%)确诊:55%的患者被发现患有感染性肠炎(其中,5例为产肠毒素大肠杆菌感染,1例为产ST的克雷伯菌感染),12%为肠道外感染,11%为牛奶不耐受。粪便中出现肉眼可见的血液(P<0.01)、白细胞和还原物质,与感染性肠炎的相关性比与其他所有原因导致的腹泻更为常见。14例患者(其中8例营养不良)腹泻病程延长。总体而言,最终结果是良好的。我们的研究结果在证实感染性肠炎是儿童急性腹泻的主要原因的同时,强调了肠道外感染和牛奶不耐受在这种情况下的重要性。此外,强调了在排除肠杆菌的致病作用之前,需要准确检测其产肠毒素能力。

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