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临床讨论本病例具有下述特点:①患者系农村老年妇女.②起病急,病程短。③临床上具备恶寒、发热、腹泻,伴血便、恶心、呕吐,及渐进性上腹和右下腹疼痛,腹肌紧张,全腹压痛等.④呈弛张热型。白细胞增高,核左移。两次大便内均未查出阿米巴原虫。X 线腹部透视未发现液平段和游离气体。⑤普通的抗感染、抗休克治疗无效,手术切除病变组织,未能幸存。据上述特点该病人可考虑以下几种疾病:1、急性重型细菌性痢疾:患者在流行季节发病,除临床症状外,大便镜检可见粘液和脓球,按菌痢治疗,腹泻基本控制。但患者大便次数少,4～5次/日,无里急后重感,呈血便而并非脓血便.治疗后,高热不退,腹痛增重,满腹疼痛,右下腹压痛,腹肌紧张及血压下降等。剖腹探查:盲
The clinical discussion of this case has the following characteristics: ① patients with rural elderly women. ② acute onset, short course. ③ clinically with aversion to cold, fever, diarrhea, with bloody stools, nausea, vomiting, and progressive abdominal pain and right lower quadrant, abdominal muscle tension, abdominal tenderness and so on. WBC increased, left nuclear shift. No detection of amoeba twice in the stool. X-ray abdominal section found no fluid level and free gas. ⑤ common anti-infective, anti-shock treatment is invalid, surgical removal of diseased tissue, failed to survive. According to the above characteristics of the patient can consider the following diseases: 1, acute severe bacillary dysentery: the patient in the epidemic season onset, in addition to clinical symptoms, stool microscopy visible mucus and pus ball, according to bacillary dysentery treatment, basic control of diarrhea. However, the number of patients with stool less, 4 to 5 times / day, no temper and heavy sense was bloody stool and not pus and blood stool. After treatment, high fever, abdominal pain, weight gain, full abdominal pain, right lower quadrant tenderness, abdominal muscle tension and decreased blood pressure. Caesarean exploration: blind