李×，男，52岁，因反复腹痛、腹泻2年，再发7天，于2001年8月12日下午4时入院

发布时间：2017-06-23 06:57 │ 来源：www.tikuol.com

题型：问答题案例分析题

问题：

李×，男，52岁，因反复腹痛、腹泻2年，再发7天，于2001年8月12日下午4时入院。

患者自述于1999年7月因受凉后出现腹泻，约10次/天。初为稀便，后为脓血便，伴有里急后重感，畏寒、发热，体温39℃，伴腹痛，阵发性，便后可缓解，服“磺胺药”治疗2天后上述症状消失而自行停药。此后常间断出现腹痛、腹泻，服“痢特灵”及“氟哌酸”后可缓解，2001年8月5日因受凉后再度出现腹痛腹泻，自服“氟哌酸”无效而入院诊治。发病以来精神差，体重无明显下降。既往体健。否认其他传染病史。

体查：体温37.0℃，脉搏70次/分，呼吸18次/分，血压120/80mmHg，发育正常，营养中等，慢性病容，神清合作，皮肤粘膜无黄染，无明显失水体征，心肺检查无异常，腹平软，肝脾肋下未触及，下腹部压痛，无反跳痛，肠鸣音正常。双下肢无浮肿。

大便常规：粘液便，红细胞(+)，白细胞(++)，脓球(+)/HP。血常规：血色素130g/L，白细胞9.0×10⁹/L，中性粒细胞0.82，淋巴细胞0.18。

本病最可能的诊断是什么?

考点：传染病学(医学高级)第五节细菌性痢疾第五节细菌性痢疾题库

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