细菌性痢疾与其他感染性腹泻的早期临床对比分析 FREE

Comparison between bacillary dysentery and other infective diarrhea during early clinical stage FREE

摘要:

目的 对比研究细菌性痢疾(简称菌痢)和其他感染性腹泻的流行病学及临床症候特点，以提高临床医生对二者的非细菌学简易鉴别能力。方法 对140例临床菌痢与349例其他感染性腹泻患者的流行病学和临床资料进行对比研究，同时再通过多因素分析筛选鉴别两者的相关因素。结果菌痢与其他感染性腹泻好发季节有所不同（P＜0.05），前者夏季多发，后者秋季更为多见。菌痢患者发热、里急后重、黏液便、脓血便及左下腹压痛较其他感染性腹泻多见，而后者以恶心呕吐、水样便及稀便较多见，差异均有显著性（均P＜0.05）。二分类Logistic回归分析发现，发病季节、里急后重、发热、大便性状及左下腹压痛5个因素与菌痢的诊断密切相关。结论发热、里急后重、黏液便及左下腹压痛是临床诊断菌痢和其他感染性腹泻的主要鉴别点。

Abstract:

ObjectiveTo compare the epidemiological and clinical characteristics of bacillary dysentery and other infective diarrhea for better nonbacteriological diagnosis and differential diagnosis .MethodsEpidemiology and clinical manifestations of 140 bacillary dysentery and 349 other infective diarrhea cases were retrospectively studied, Logistic regression analysis was used to screen the related factors for differentiating bacillary dysentery from other infective diarrhea. ResultsPeak seasonal difference was found statistically significant in the occurrence rate of bacillary dysentery and other infective diarrhea（P＜0.05）,  the former  was in summer time and the latter in autum. Fever, tenesmus, mucous stool, pus and blood stool and tenderness on left lower quadrant were found more frequent in bacillary dysentery cases than in other infective diarrhea, but nausea, vomiting, watery stool and loose stools were the main clinical characteristics of the latter（all P＜0.05）. Logistic regression analysis showed that  attacked season, tenesmus, fever, mucous stool and tenderness on left lower quadrant were proved to have significant correlation with clinical diagnosis of bacillary dysentery.ConclusionFever, tenesmus, mucous stool, and tenderness on left lower quadrant are the main differential points  between clinically diagnosed bacillary dysentery and other infective diarrhea.