輪狀病毒胃腸炎之臨床觀察

Clinical Observation Rotavirus Gastroenteritis in Children

林金龍(Chin-Long Lin) ； 黃富源(Fu-Yuan Huang) ； 邱世昌(Shr-Chang Chyou) ； 李宏昌(Hung-Chang Lee)

《Acta Paediatrica Sinica》 25卷4期 (1984/12) Pp. 407-411

摘要

輸狀病毒胃腸炎是好發於幼兒身上的一種高度傳染性疾病，主要流行於冬天的月份。診斷上，除了電子顯微鏡外，enzyme immunoassay (Rotazyme(上標 ®))已被證實爲迅速而準確的一種診斷方法。馬偕醫院自民國72年1月至72年12月，以Rotazyme(上標 ®)檢查了，209例因急性胃腸炎而住院病童的糞便，發現91例(43.5%)陽性者，所有91例均視爲輸狀病毒胃腸炎而納入本研究。其中，男孩佔55例。年齡分佈由40天大至4歲2個月。季節分佈以較冷的月份居多，尤其11、12月是流行高峯。臨床表徵以水瀉最多91例(100%)，其次爲嘔吐76例(83.5%)，發燒70例(76.9%)，咳嗽48例(52.7%)，鼻炎34例(37.4%)，中度以上脫水4例(4.4%)痙攣9例(9.9%)，胃腸道出血1例(1.1%)。實驗室檢查方面，白血球平均值10,634±4,194/mm^3(26,500~3,900/mm^3，Mean±SD),鈉136.6±3.7mEq/L(145~126mEq/L),鉀4.3±0.8mEq/L(6.4~2.3 mEq/L)。大便常規檢查，有陽性潛血反應者佔19%。大便細菌培養有2例同時培養出沙門氏桿菌，1例志賀桿菌。除了1例在臨床上疑似Reye's syndrome，明顯的後遺症外，其餘90例均完全康復。

並列摘要

Human rotavirus is now accepted as one of the most important causes of child-hood gastroenteritis. Rotazyme(superscript ®) test had been proved to be as sensitive and specific as electron microscopy for detection of rotavirus in human stools. From January 1983 to December 1983, a total of 209 cases were admitted to Mackay Memorial Hospital due to gastroenteritis. Their stools were sent for Rotazyme(superscript ®) test. Ninety-one cases (43.5%) showed positive results and were enrolled in this study. There were 55 boys and, 36 girls. Most cases (74/91, 81.3%) occurred in the winter (Novemberber, December and January). The age ranged from 40 days to 4 years and 2 months, with a peak between 6 and 24 months (70.4%), however it was not uncommon in infants less than 6 months (20.9%). Watery diarrhea (100%), vomiting (83.5%) and fever (76.9%) were the most common signs and symptoms and they often occurred simultaneously. On average, the diarrhea, vomiting and fever lasted for 4.9, 2.1 and 2.8 days, respectively. Forty-eight cases (52.7%) had upper respiratory tract symptoms which preceded about 3 to 4 days the onset of diarrhea. Five cases had penumonia or bronchiolitis. Only 4 cases had moderate to severe dehydration while another one case was thought to have Reye-like syndrome. One case had self-limited gastrointestinal bleeding. Most cases were treated successfully by oral fluid restriction for 1 to 2 days and concomitant intravenous fluids. Feeding was started with glucose electrolyte solution or half-strength soy bean milk and then changed to full strength formula gradually. The prognosis was good, 90 cases recovered completely after treatment and the case thought to have Reye-like syndrome had sequela.

並列關鍵字

rotavirus ； gastroenteritis ； Rotazyme(上標 ®)