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目的分析急重度腹泻患者排泄物细菌培养结果以及临床特征,以探索临床检验与临床诊断的相关性。方法选取2014-2015年间于恩施土家族苗族自治州中心医院就诊的急重度腹泻患者共120例,对其排泄物做细菌培养,分析急性腹泻临床特征,与诊断结果做对比。结果 120例患者中包含急性肠炎50例,胃肠功能紊乱40例,急性菌痢15例,消化不良8例,腹泻待查7例。粪便细胞培养阳性有40例占33.3%。包括副溶血弧菌14例,沙门菌5例,类志贺邻单包菌5例,志贺菌属11例,温和气单胞菌3例,霍乱弧菌2例。40例粪便细菌培养阳性患者临床诊断结果为:急性菌痢10例(阳性率66.7%),急性肠炎17例(阳性率34%),胃肠功能紊乱8例(阳性率20%),消化不良1例(阳性率为12.5%),腹泻待查4例(阳性率为57.1%)。结论急重度腹泻肠道致病菌主要以副溶血弧菌和志贺菌属为主。应根据患者临床表现,做便常规,血常规检查,并参考粪便细菌培养结果进行诊断。
Objective To analyze the bacterial culture results and clinical features of excrement in patients with severe acute diarrhea to explore the correlation between clinical tests and clinical diagnosis. Methods A total of 120 patients with acute and severe diarrhea were enrolled in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture during 2014-2015. The excrement was cultured in bacteria and the clinical features of acute diarrhea were analyzed. The results were compared with the diagnostic results. Results The 120 patients included 50 cases of acute enteritis, 40 cases of gastrointestinal disorders, 15 cases of acute bacillary dysentery, 8 cases of dyspepsia and 7 cases of diarrhea. Stool cell culture positive 40 cases accounted for 33.3%. Including 14 cases of Vibrio parahaemolyticus, 5 cases of Salmonella, 5 cases of monocytogenes Shishi orthopedic, 11 cases of Shigella, 3 cases of Aeromonas sobria and 2 cases of Vibrio cholerae. The clinical diagnosis results of 40 cases of positive stool bacterial culture were: 10 cases of acute bacillary dysentery (positive rate 66.7%), 17 cases of acute enteritis (positive rate 34%), 8 cases of gastrointestinal disorders (positive rate 20%), indigestion 1 case (positive rate was 12.5%), 4 cases of diarrhea pending investigation (positive rate was 57.1%). Conclusion The main pathogens of enteric pathogens in acute severe diarrhea are Vibrio parahaemolyticus and Shigella spp. Should be based on the clinical manifestations of patients, so routine, blood tests, and refer to the results of fecal bacterial culture for diagnosis.