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53例手术证实肠穿孔患者每例都有一种以上诊断指标确诊为伤寒.腹腔脓液需氧菌培养50例(94.34%),阳性率100%,主要是大肠杆菌(100%)、伤寒杆菌(78%);厌氧菌培养25例(49.15%),主要是脆弱类杆菌(88.89%).肠伤寒穿孔是多种细菌的混合感染,既有一般胃肠穿孔的特点,又有伤寒杆菌感染的特征性改变.丁胺卡那霉素对伤寒杆菌与大肠杆菌的药敏率分别为95.26%和94.52%,与甲哨唑联合应用,临床效果满意.肠伤寒穿孔的特征性改变有助于术中诊断.手术除处理肠穿孔外,主要目的是消除有利于厌氧菌生长的环境.常规营养支持可增强机体抗感染能力,提高治疗效果.本组治愈48例(90.56%),死亡5例(9.44%).
In 53 cases of operation, 50 cases (94.34%) of patients with intestinal perforation were diagnosed as typhoid in each case of intestinal perforation, the positive rate was 100%, mainly E. coli (100%), typhoid bacillus 78%). Anaerobic bacteria were cultured in 25 cases (49.15%), mainly Bacteroides fragilis (88.89%). Enterocolitis typhoid perforation is a mixed infection of many bacteria, both the general characteristics of gastrointestinal perforation, and Salmonella typhi infection The sensitivity of amikacin to Salmonella typhi and Escherichia coli was 95.26% and 94.52%, respectively, which was satisfactory with methotrexate.The characteristic changes of intestinal typhoid perforation were helpful to Surgery in addition to the treatment of intestinal perforation, the main purpose is to eliminate the environment conducive to the growth of anaerobic bacteria.Routine nutrition support can enhance the body’s anti-infective ability and improve the therapeutic effect of this group were cured in 48 cases (90.56%), 5 Example (9.44%).