推荐回答(1个)
腹泻是指排出异常稀薄的大便,或含有未消化食物,甚或脓血,并且排便次数频密,伴有排便急迫感、肛门周围不适、失禁等症状。腹泻极少是严重疾病的症状,通常不需要特殊治疗。但由于腹泻会丢失大量的肠液,多次腹泻后可造成血液中的电解质紊乱,特别是钾离子丢失过多,造成全身不适。如果腹泻持续不止或伴有脓血便、剧烈呕吐或高热,应到立即医院就诊。
一、腹泻的自我诊断要点
伴随的症状
可能的诊断
急性腹泻,水样便,可伴有(或不伴有)发热,脐周疼痛 胃肠炎,多为食用不洁、变质或使用过敏的食物引起
急性腹泻伴有发热等全身症状,并发现大便中带脓血 细菌性痢疾、阿米巴痢疾,但也不能排除溃疡性结肠炎
慢性腹泻伴发热 常见于慢性痢疾、血吸虫病、肠结核和结肠癌等
慢性腹泻还有间歇性便秘 结肠过敏、直肠或结肠息肉,还须排除结肠癌
粪便呈酱红色或血水样,含有脓血小块,量较多且有恶臭 急性阿米巴痢疾
粪便量多,恶臭异常,呈灰白色油脂状 一般为脂肪消化及吸收障碍所致的腹泻
严重腹泻,伴有剧烈呕吐、发热、严重脱水,粪便呈米泔水样,病情凶险 可能为霍乱和副霍乱
常见腹泻的病因及治疗
夏季是菌痢的高发季节,此时,沙门氏菌肠炎、由轮状病毒引起的腹泻也到了发病高峰期。由于三者在临床上均有腹痛、腹泻、呕吐等症状,易混淆诊断。此外,菌痢与沙门氏菌肠炎在抗生素的使用上不尽相同,而轮状病毒性腹泻则不需要用抗生素。因此,对三者加以鉴别,于及时治疗有重要意义。
菌痢多由食用不洁食物如蔬菜、水果等引起发病,1岁以内幼儿少见,首发症状为先泻后吐,同时有腹痛,以左下腹痛为主,腹泻的特点是便次频繁,每日大便次数超过十次,甚至更多,但大便量少,大便性状为粘液或脓血便,里急后重明显,大便镜检满视野白细胞,大使培养可查到志贺氏菌。氟哌酸为目前最佳抗痢药物。
沙门氏菌肠炎多由食用不洁食物如牛奶、蛋类、家禽、内脏等引起发病,1岁以内幼儿多见。首发症状为先吐后泻,常有呕吐,以脐周腹痛为主,每日便次在3-10次,大便量多,大便性状为水样带粘液,里急后重不明显,大便镜检白细胞总数多正常,大便培养可找到沙门氏菌,治疗药物选用复方新话明、氯霉素、氨苄青霉素或第三代头孢菌素。
轮状病容是6岁以下幼童非细菌性腹泻的主要病原,以6个月~2岁小儿发病率最高。轮状病毒性腹泻首发症状为呕吐、咳嗽,腹泻每日3-10次,大便为稀便、水样或蛋花样。有酸臭味,无粘液及脓血,大便镜检、大便培养均阴性,血象不高,病毒检测可分离出轮状病毒。如果没有继发细菌感染,可不用抗菌药物。
抓“肚筋”医治拉肚子
因受凉而引起的拉肚,可用抓“肚筋“的方法来治疗。让患者俯卧于床上,可在患者两肩胛骨内侧分别抓住一根较粗的筋“即肚筋”。抓住此筋提起来,再猛地松开,这样左右如是几次,便有奇效。
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