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目的了解北京市昌平区腹泻病例流行病学特征,评价细菌性痢疾的诊断符合情况,降低临床诊断误诊率。方法按照卫生行业标准(WS287-2008)对昌平区312例腹泻病例进行个案调查,对患者粪便样本进行痢疾志贺菌培养。结果检出痢疾志贺菌38份,检出率为12.18%(38/312),其中细菌性痢疾临床诊断病例中志贺菌检出率为17.19%(22/128),感染性腹泻病例中志贺菌检出率为12.80%(16/125)。农民工、农民的检出率较高;有发热、粘液便、脓血便等典型症状的腹泻病例样本检出率高;散居儿童临床诊断病例诊断符合率低。结论细菌性痢疾的临床误诊率较高,应逐步提高实验室诊断比例。
Objective To understand the epidemiological characteristics of diarrhea cases in Changping District of Beijing, assess the coincidence of the diagnosis of bacterial diarrhea and reduce the misdiagnosis rate of clinical diagnosis. Methods A total of 312 cases of diarrhea in Changping District were investigated according to the hygiene industry standard (WS287-2008), and Shigella dysenteriae was cultured on the stool samples of patients. Results Thirty-seven Shigella dysenteriae were detected, the detection rate was 12.18% (38/312). The detection rate of Shigella in clinical diagnosis of bacterial dysentery was 17.19% (22/128). In the case of infectious diarrhea Shigella detection rate was 12.80% (16/125). The detection rate of migrant workers and peasants is high. The detection rate of diarrhea cases with typical symptoms such as fever, mucus, pus and blood stool is high, and the diagnostic coincidence rate of diaspora in clinically diagnosed diaspora is low. Conclusion The clinical misdiagnosis rate of bacillary dysentery is high, and the proportion of laboratory diagnosis should be gradually increased.