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病史资料:6例中,男2例,女3例,年龄17～46岁。全部病例均表现持续高热,热程12～19天,肥达氏反应H1320,O1:160以上,4例血培养分离出伤寒杆菌。上腹痛发生于热程第7～13天,伴呕吐5例,均表现有左上腹压痛,1例巩膜黄染。血白细胞计数3.6～9.8×10~9/L,血淀粉酶625～1200U(苏氏法)。B超检查具有急性胰腺炎改变者3例,无1例合并胆石症。6例中2例首先诊断为急性胰腺炎并予禁食、输液、肌注654-2等治疗,但发热不退,腹痛无缓解。全部病例于疑诊或确诊伤寒后分别应用氯霉素、丁胺卡那霉素及氟哌酸等治疗,体温逐步下降至正常,腹痛随之缓解至消失,血、尿淀粉酶亦恢复正常。6例中并发肠出血、中毒性心肌炎和肝功能损害各1例。
History data: 6 cases, 2 males and 3 females, aged 17 to 46 years. All cases showed sustained high fever, heat 12 to 19 days, Widal reaction H1320, O1: 160 or more, 4 cases of blood cultures isolated Salmonella typhi. Upper abdominal pain occurred in the heat of the first 7 to 13 days, with vomiting in 5 cases, showed the left upper quadrant tenderness, scleral 1 case of yellow dye. Blood white blood cell count 3.6 ~ 9.8 × 10 ~ 9 / L, blood amylase 625 ~ 1200U (SU’s method). B-ultrasound with acute pancreatitis in 3 cases, no one with cholelithiasis. In 6 cases, 2 cases were firstly diagnosed as acute pancreatitis and treated with fasting, infusion and intramuscular injection of 654-2. However, the symptoms were mild and no pain was relieved. All cases were treated with chloramphenicol, amikacin and norfloxacin respectively after the suspected or confirmed typhoid, the body temperature gradually decreased to normal, abdominal pain then eased to disappear, blood and urine amylase returned to normal. 6 cases of intestinal bleeding, toxic myocarditis and liver dysfunction in 1 case.