湘西少数民族地区儿童伤寒临床特点分析

对湘西自治州人民医院自1992年1月至2002年12月收治的432例伤寒儿童病例临床资料进行分析，结果显示：所有儿童均发热，伴消化道症状者198例（45.83%），肝脏肿大者345例（79.86%），脾脏肿大者86例（19.90%）；256例患儿出现并发症，并发肺炎129例（29.86%），伤寒肝炎64例（14.8%），心肌炎52例（12.04%），肠出血、肠穿孔很少见；白细胞在正常范围者302例（69.91%），嗜酸性粒细胞绝对计数为0者345例（79.86%）.药敏报告表明伤寒杆菌对氯霉素的耐药性明显下降，对氨基糖苷类抗生素几乎不耐药，而氨苄青霉素尤其是复方新诺明耐药较多，几乎所有菌株对第3代头孢菌素、喹诺酮类敏感.结论：伤寒病6岁以上学龄儿童为主要患病人群，临床表现不典型且复杂，嗜酸性粒细胞为0仍是儿童伤寒的1个特点，治疗儿童伤寒以第3代头孢菌素疗效好.

Analysis of Characteristic of Typhoid Fever Among Children in the Minority Nationality Region in Western Hunan From 1992 to 2002

Objective:To understand the features of children's typhoid fever in the minority nationality region in Western Hunan.432 Methods:hospitalized children identified as typhoid fever were analyzed retrospectively.Results:All patients had fever and most of them were complicated with gastrointestinal tract symptoms.345 (79.86%) cases had hepatomegaly of which 86(19.90%) had splenomegaly,256 patients had complications including bronchitis-pneumonia (29.86%) hepatitis (14.8%) myocarditis (12.04%) and others.But rectal bleeding and intestinal perforation were seldom observed.White blood cell accounts were normal in (69.91%) children.Eosinophil accounts were decreased to zero in the major patients (79.86%).Antibiotics sensitive tests revealed that aminoglycosides,the third generation cephalosporins and Huroquinolones drags were sensitive to salmonella typhi chloramphenicol resistance to salmonella typhi decreased.Ampicillin and Compound Sulfamethoxazole resistance were common.Conclusions:Typhoid fever is present all year round but more prevalent in summer,and usually affects Children over 6 years of age.The clinical characteristics are atypical and complex.Zero of eosinophil accounts is still a major clue for typhoid fever.The third generation cephalosporins antibiotics show good effectivity in the treatment of children's typhoid fever.