Alarcón Menendez P, Alarcón Mangini J L
Rev Gastroenterol Peru. 1994 May-Aug;14(2):145-9.
Acute childhood diarrhea is highly common in our country and its treatment include rehydration, the early dietary management and in few cases the use of antibiotics. At the same time, watery diarrhea is much more common than bloody diarrhea. The ideal in the management of infectious diarrhea is to identify the microorganisms that are producing the disease, however, it is very important to mention that in the majority of etiological studies done in our country, two were the more common identified microorganisms: Rotavirus and E. coli (in its different types). Usually and due to the high price of Lab. tests, we don't search those microorganisms and the majority of Laboratories used to report as a result, Salmonella, Shigella or negative. Normally, we receive the results of these cultures after few days and as we can understand these results are not necessarily useful in the early management of the disease and as we mentioned, these results will not include the more common pathogens. In this article we propose to perform three simple fecal tests in patients affected with acute diarrhea: 1) Count and differentiation of leucocytes; 2) Occult blood; 3) Reducing substances. If we play with these three results, it is not too difficult to suspect in the probable pathogen that is affecting our patient. In that concern, we propose this very simple, cheap and highly practical method for the etiological management of our patients that, of course, is not infallible, but our experience for many years have shown us that it is of great help for pediatricians in their daily work.
急性儿童腹泻在我国极为常见,其治疗方法包括补液、早期饮食管理,少数情况下使用抗生素。同时,水样腹泻比血性腹泻更为常见。感染性腹泻管理的理想做法是识别引发疾病的微生物,然而,必须指出的是,在我国进行的大多数病因学研究中,两种较为常见的已识别微生物是:轮状病毒和大肠杆菌(不同类型)。通常由于实验室检测费用高昂,我们不会查找这些微生物,而且大多数实验室报告的结果是沙门氏菌、志贺氏菌或阴性。正常情况下,我们几天后才能收到这些培养结果,正如我们所能理解的,这些结果在疾病的早期管理中不一定有用,而且如我们所述,这些结果不会包括更常见的病原体。在本文中,我们建议对急性腹泻患者进行三项简单的粪便检测:1)白细胞计数与鉴别;2)潜血;3)还原物质。如果综合这三项结果,不难推测出感染患者的可能病原体。出于这一考虑,我们提出这种非常简单、廉价且高度实用的患者病因管理方法,当然,它并非万无一失,但我们多年的经验表明,它对儿科医生的日常工作有很大帮助。