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1、腹泻病第十一章第八节1Vocabularyhypochlorhydria－胃酸过少normalflora－正常菌丛colibacillus－大肠杆菌campylobacter－弯曲菌Yersinia－耶尔松菌adenylcyclase－腺苷酸环化酶guanyliccyclase－鸟苷酸环化酶microvillares－微绒毛Staphylocaccusaureus－金黄色葡萄球菌pseudomembranousenterocolitis－伪膜性小肠结肠炎2小儿腹泻InfantileDiarrhea目的要求Objective概述Summary病因Etiology发病
2、机制Pathogenesis临床表现Clinicalmenifestations诊断、鉴别诊断Diagnosis&DifferentialDiagnosis治疗原则PrincipleofTreatment3目的要求Objective掌握本病的病因、发病机制与临床表现Mastered：Etiology,Pathogenesis&Clinicalmenifetation掌握本病的诊断与治疗Mastered：Diagnosis&Treatment熟悉本病的鉴别诊断Befamiliarwith：DifferentialDiagnosis了解本病的预防Realized：Pr
3、event4概述Summary小儿腹泻(腹泻病)，是由多病原、多因素引起以腹泻为主的一组疾病，容易并发水、电解质、酸碱平衡紊乱。根据病因可分为感染性（较多见）和非感染性两类，发病年龄多在2岁以下，1岁以内者约占半数。近30年来本病发病率和病死率已明显降低，但仍是小儿的常见病和死亡原因。Infantilediarrheaiscausedbymulti-pathogeny&multifactor.Themainsymptomisdiarrhea.Itiseasilycomplicatedbydisturbancesofwater,electrolyteandacid-
4、basebalance.Accordingaspathogeny,itcanbeclassifiedbytheinfected(most)andthenon-infected.Itoccursusuallylessthan2yearsold,about50%lessthan1year.Althoughtheincidenceandthemortalityofthediseasehaveevidentlydecreasedbylate30years,itoftenoccursininfantsandresultsininfants’death.5病因Etiology
5、一、易感因素Predisposingfactors1.消化系统特点(胃酸↓,消化酶↓,酶活性↓,生长发育快)Characteristicofdigestivesystem(hypochlorhydria,digestenzyme↓,enzymaticactivity↓,fastdevelopingandgrowth)2.机体防御功能较差(胃酸↓,免疫球蛋白↓,SIgA↓,正常菌丛)Organismdefensehypofunction(hypochlorhydria,immuneglobulin↓,SIgA↓,normalflora)3.人工喂养Non-human
6、-milkfeed6二感染因素Infectedfactors1.肠道内感染(细菌、真菌、病毒、寄生虫)Intestinaltractinfection(bacteria,fungus,virus,parasite)2.肠道外感染(中耳炎、上感、肺炎、皮肤感染等)Extraintestinaltractinfection(tympanitis,upperrespiratorytractinfection,pneumonia,skininfectionetc)三非感染因素Noninfectiousfactors1.饮食因素Food2.气候因素Climate7肠内感染常
7、见病原Pathogenyofinfectioninsideintestinaltract1.大肠杆菌Colibacillus(EPECETECEIECEHECEAEC）2.弯曲菌Campylobacter1972Belgium－1981Shanghai3.耶尔松菌Yersinia1973USA－1980Fujian4.抗生素诱发的肠炎Enteritisresultedfromantibiotics5.轮状病毒Rotavirus1973Australia－1978Beijing8肠毒素不耐热肠毒素耐热肠毒素腺苷酸环化酶鸟苷酸环化酶CGMP↑CAMP↑Na+Cl-H2
8、O↑小肠液
