记述-一例新城疫与流感混感继发大肠杆菌病例治疗全过程
2012年山东省菏泽市温某饲养白羽肉鸡6000羽，十一月中旬进雏，一周内死亡800余只。确认沙门氏菌感染，后继发败血性大肠杆菌，死亡一直持续着，每天死亡约20只左右，曾用药氧氟沙星 头孢及氟苯尼考类抗生素治疗。直至18日龄病情有所好转！死亡略微减少。但伴随着呼吸道症状，多以咳嗽甩鼻为主要特征。停药两天后，21日龄养殖户加免，ND（IV)疫苗，随即养殖户拿部分死鸡到我处就诊，共剖检11只，剖检变化为：口腔 鼻腔粘液增多，喉头气管轻度出血，气囊浑浊，肺水肿心脏有纤维素渗出物，肝脏有纤维素渗出。盲肠扁桃体肿大轻度出血，肾脏肿大严重（★★★★★）并呈花斑样，输尿管增粗，内有白色尿酸盐阻塞。剖检11只其中9只花斑肾明显，后到场查看，发现约占30%鸡只，肛门不洁有白色污染物。粪便以白色稀粪为主！初诊 “肾型传染性支气管炎”。出具治疗方案为：一、控制病毒 二、防治继发感染 三、通肾利尿、恢复肾功能 四、调节机体电解质，补充营养。治疗药物为统灭1000只/瓶配合优瑞克II 250斤/瓶对水 肾支宁（乌洛托品 牛磺酸）200斤/瓶五苓散2g/只鸡沏水拌料。除用药期间葡萄糖2%加小苏打0.2%自由饮水，连续四天。治疗第三天死亡率明显下降，据该养殖户反映第六天时死亡突然增加，呼吸道症状明显，开始减料20%，（预期、新城疫起来了）随即剖检十余只死鸡，确诊中发型新城疫。建议他到畜牧局做进一步化验，随后该养殖户到菏泽市畜牧局化验，结果为新城疫与大肠杆菌混感。开了两天治疗药，两天后死亡减轻，后建议养殖户在投喂两天，该养殖户带病料再次就诊，诊断为呼吸道及大肠杆菌没有病毒。又投喂两天后，死亡再次增加，并出现肿头现象排黄绿色稀便，羽毛逆立，食欲减退，饮欲增强，精神萎靡，严重呼吸困难，病理剖检为，鸡体脱水，肛门不洁，脚趾鳞片出血，眼睑肿胀，口腔粘液增多喉头气管充血出血严重支气管内有黄色干酪样物质阻塞，胸腺肿大 出血（个别鸡胸腺萎缩）囊浑浊增厚，腹气囊及腹膜有黄色干酪样物质，肺出血水肿，边缘有虾肉样变，心脏有纤维素渗出，心包积液，心外膜出血，心肌变性，心冠脂肪出血，心耳淤血，有胶冻样浸润，心内膜出血。肝脏肿大，质地易碎，覆有白色纤维素性渗出物，脾脏有粟粒大小坏死灶，腺胃乳头出血，肌胃角质层下出血，胰腺散在出血点，小肠段呈出血性卡他性炎症，盲肠扁桃体肿大出血，直肠呈弥漫性出血，泄殖腔出血，内有黄白色宿便。法氏囊肿大（个别鸡萎缩)法氏囊不洁。肾脏肿大（★★★）出血！初步诊断：新城疫与流感混合感染继发大肠杆菌
治疗方案：一、抗病毒 退烧缓解症状二、控制继发感染 减轻并发症 三、迅速恢复机体免疫力 提高抗体 四、补充营养 加强消毒 饲养管理 防治二次应激
治疗药物：上午；国杆无敌300斤/瓶加安乃近10斤/g集中饮水；下午 ；普欣200斤/瓶 加呼康宁300斤/袋集中饮水。复方甘草片3只/片加安乃近15只/片。用药间隔两小时3%葡萄糖和速补自由饮水八小时！
回访：用药三天，基本控制死亡每天死亡在5-10只，采食量上涨，建议巩固一天，后期黄芪多糖拌料五天。（直至出栏死亡再未增加，养殖户赚2000元，为此相当满意）
病例部分照片 仅供参考
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鸡眼睑肿胀
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病鸡精神沉郁 羽毛逆立
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病死鸡只皮肤暗红，头 喙淤青脚趾出血
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腺胃乳头出血 肌胃角质层下出血
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脚趾鳞片出血
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腺胃乳头出血
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腺胃乳头 出血 肌胃角质层下出血
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脚趾鳞片出血
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病鸡肛门污染，黄白色稀便
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气囊浑浊 增厚 内有黄色干酪样物质
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肾脏肿大 睾丸出血
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支气管栓塞
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直肠及泄殖腔内米粥样稀便 法氏囊不洁
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总结：一、在病毒病发病期间，不能进行免疫。（该养殖户21做加免加重病情）
二、作为技术人员，应该对疾病发生发展，做出正确判断，切勿盲目用药。
三、在传染病发生的不同阶段，应该采取不同应对方案。
四、传染病流行的原因有三点；1、（消灭）传染源 2、（切断）传播途径 3、（保护）易感动物
五、疾病发展的四个阶段要清楚；1、潜伏期 2、前驱期 3、症状明显期 4、转归期（尽量做到早发现早治疗）
六、治疗疾病过程中要掌握；1、控 2、治 3、防 4、护 5、补《控、控制死亡，究其死亡原因，对症治疗（急则治标、缓则治本）。治、正确使用抗病毒药物，切勿盲目使用（病毒药杀鸡无罪 通肾药救命无功）。防、选用防治继发感染药物时，要理性。对一些严重肝肾功能衰竭病例，尽量避开氨基糖苷类磺胺类药物的使用。护、治疗疾病过程中，一定敦促养殖户配合，做好消毒，护理工作。补、在疾病预后期，增加营养及提高抗体药物的使用。
七、我的病历写完了，“学不学于你 写不写在我”学而不思则罔 思而不学则殆
国威动物药业有限公司技术部
王金明
2013年5月14日
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