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我院1973年1月至1978年12月确诊伤寒副伤寒220例(除1例骨髓培养阳性外,余均由血培养证实),其中误诊77例(伤寒69例,副伤寒甲3例,副伤寒乙5例)。本文就误诊病例予以粗浅分析,以便从中吸取经验教训,不断提高诊断水平。资料分析一、临床表现近年来伤寒的许多临床特点在发生强度与频度上均有所改变,诸如神经系统中毒症状明显减少;热型以弛张和不规则居多;伤寒的特征性表现如表情淡漠、相对缓脉、玫瑰疹、脾肿大等均有减少,而肝大的检出率有所增高。本组病例多不典型,其主要临床表现见表1。
From January 1973 to December 1978, 220 cases of typhoid and paratyphoid fever were confirmed in our hospital from January 1973 to December 1978, except for one case of bone marrow culture, all of which were confirmed by blood culture. Among them, 77 cases were mistaken (69 cases of typhoid fever, 3 cases of paratyphoid fever, Typhoid B 5 cases). This article gives a superficial analysis of misdiagnosed cases in order to learn from them and continuously improve the diagnostic level. Data Analysis First, the clinical manifestations of many clinical features of typhoid fever in recent years have occurred in the intensity and frequency have changed, such as nervous system symptoms significantly reduced; fever to relaxation and irregular majority; typhoid characteristic manifestations such as expression Indifference, relative slow pulse, rose rash, splenomegaly, etc. have decreased, while the detection rate of liver increased. This group of patients atypical, the main clinical manifestations in Table 1.