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钩端螺旋体病肺大出血发病原理迄今未获阐明。临床和实验研究初步揭示了钩体病肺大出血中一类型——发展迅猛异常,如不及时抢救,短期内发生全肺大出血、口鼻涌血而死。其发病原理是机体对血液、组织细胞中毒力强、数量多的钓端螺旋体及其有毒物质产生的强烈反应。尽管采用青霉素治疗,但短期内仍有部分病员从流感伤寒型重型或肺出血一般型演变为肺大出血早期,或从肺大出血早期发展为大出血期,甚至肺大出血危险期,严重威胁病人的生命。对这种病人,我们在青霉素治疗的同时采用静脉滴注“药理剂量”的氢化可的松,部分病员,尤其是肺大出血早期,疗效较好,病员迅速转危为安,完全恢复健康。现将81例钩体病肺大出血病例进行分析,以期进一步寻找适合我国农村基层条件的抢救措施。
Leptospirosis disease pathogenesis of pulmonary hemorrhage hitherto unknown. Clinical and experimental studies have initially revealed that leptospirosis is one of the major types of pulmonary hemorrhage - a rapidly developing abnormality. If not promptly rescued, major pulmonary hemorrhage occurs in a short period of time and the oral cavity and nose bleed. The pathogenesis of the body is the blood, tissue cells strong virulence, a large number of Tropospores and their toxic substances produce a strong reaction. In spite of the penicillin treatment, some patients in the short term still have a serious threat to the patient’s life from the common type of severe or bleeding haemorrhagic fever of influenza type to the early stage of pulmonary hemorrhage, or from the early stage of pulmonary hemorrhage to the bleeding phase or even the risk of pulmonary hemorrhage. For such patients, we use intravenous infusion of “pharmacological dose” of hydrocortisone in the treatment of penicillin. Some patients, especially the early stage of pulmonary hemorrhage, have better curative effect and the patients are quickly turned around and return to full health. Now 81 cases of leptospirosis cases of pulmonary hemorrhage were analyzed in order to further find suitable for China’s rural grass-roots conditions of the rescue measures.