(1) The process of a typical case is divided into three stages.
1. Most patients with diarrhea and vomiting begin with acute diarrhea and vomiting. Diarrhea is painless, and a few patients may have abdominal pain due to rectus abdominis spasm, without acute abdominal pain and severe abdominal pain. The stool begins to be turbid or watery, with feces; It quickly turns into a rice swill-like or colorless transparent water sample, with no fecal odor, slightly sweet or fishy smell, and contains a lot of flaky mucus. A few critically ill patients occasionally bleed, so the stool is a meat-washing water sample, and the bleeding can be tar-like, mostly Eirto type. The amount of stool is large, which can exceed 1000ml each time, more than ten times a day, and it is even difficult to count. Vomiting usually occurs after diarrhea, and it is often jet-like and continuous. Vomiting comes first from the contents of the stomach, and then from the water. The serious person can be like "rice swill", and the light person can have no vomiting. This period lasts several hours to 1 ~ 2 days.
2. During the dehydration period, due to frequent diarrhea and vomiting, a large amount of water and electrolytes are lost, and patients will soon experience dehydration and microcirculation failure. The patient is indifferent, sluggish or excited, and the child may be in a coma. Thirst, hoarseness, shortness of breath, tinnitus, sunken eyes, sunken cheeks, dry lips, cold skin, loss of elasticity, wrinkled fingers, etc. Muscle spasms are more common in gastrocnemius and rectus abdominis. The abdomen is boat-shaped and has a sense of flexibility. Slow or unreachable pulse, low blood pressure. The body surface temperature drops, the anal temperature of adults is normal, and the anal temperature of children is much higher. This period usually lasts for several hours to 2 ~ 3 days.
3. After the dehydration of convalescent patients is corrected in time, most symptoms disappear and return to normal, and the number of diarrhea decreases or even stops. Voice recovery, moist skin and increased urine output. About13 patients have reactive fever, and a few patients, especially children, may have high fever.
(2) Clinical types According to clinical manifestations, cholera can be divided into five types.
1. After asymptomatic infection, there are no symptoms. Originally, bacteria are only excreted, and they are called contacts or healthy carriers. The period of bacteria excretion is generally 5 ~ 10 day, and individuals can be delayed to months or years and become chronic carriers.
2. Mild patients have slight discomfort, diarrhea several times a day, thin stool, generally no vomiting and dehydration, normal blood pressure and pulse, plasma specific gravity between 1.026 ~ 1.030, and no obvious decrease in urine volume.
3. Moderate vomiting and diarrhea are frequent, reaching 10 ~ 20 times a day. The stool is rice swill-like, with a certain degree of dehydration. The blood pressure is decreased (systolic blood pressure is 9.31~12kpa) (90 ~ 70mmhg), the pulse is rapid, the plasma specific gravity is1.031~1.040, and the 24-hour urine output is below 500ml.
4. Severe vomiting and diarrhea, severe dehydration, low blood pressure, even undetectable, weak pulse and often inaccessible, plasma specific gravity > 1.5438+0, little or no urine. ..
5. Fulminant cholera, also known as dry cholera, is very rare. Sudden onset, not waiting for diarrhea and vomiting, that is, death due to circulatory failure.