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本文分析了我院自1974年1月至1978年12月五年间44例伤寒患者入院时误诊的原因.通常误诊的疾病有:病毒感染、沙门氏菌感染、败血症、疟疾、结核病、腹膜炎及消化道出血等.最主要的原因是由于伤寒的某些临床表现异常,轻型和不典型的病例增多所致.为进一步提高本病的诊断率作者提出了粗浅的意见,即凡持续一周以上的发热,伴有白细胞减低(或无明显增高)的患者,出现下列任何一种情况时,均应疑为伤寒的可能:1.早期腹泻,便稀而无脓血,镜检无脓球及吞噬细胞,培养阴性者;2.肝肿大或脾肿大,特别要注意在病程中触及脾肿大者,3.发热、头痛、呕吐及脑膜刺激征阳性,而脑脊液检查正常者;4.有不同程度的消化道症状,右下腹轻度压痛,突然发生下消化道出血,或类似阑尾穿孔的腹膜炎表现者.
This article analyzes the causes of misdiagnosis of 44 typhoid patients admitted to our hospital from January 1974 to December 1978. Commonly misdiagnosed diseases are: viral infections, Salmonella infections, sepsis, malaria, tuberculosis, peritonitis and gastrointestinal bleeding Etc. The main reason is due to some of the clinical manifestations of typhoid fever, mild and atypical cases of increased cases.To further improve the diagnosis of the disease the author put forward a superficial opinion, that who last for more than a week of fever, with In patients with leukopenia (or no significant increase), any one of the following conditions should be suspected of typhoid fever: 1. Early diarrhea, it is rare without sepsis, microscopic examination without pus and phagocytic cells, culture Negative; 2 hepatomegaly or splenomegaly, with particular attention to contact with splenomegaly in the course of the disease, 3 fever, headache, vomiting and meningeal irritation sign positive, and cerebrospinal fluid examination was normal; 4 have varying degrees of Gastrointestinal symptoms, mild tenderness in the right lower abdomen, sudden onset of lower gastrointestinal bleeding, or peritonitis similar to perforation of the appendix.