中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2013年
25期
1-2,3
,共3页
艰难梭菌%艰难梭菌相关性腹泻%抗生素相关性腹泻%临床特点%危险因素
艱難梭菌%艱難梭菌相關性腹瀉%抗生素相關性腹瀉%臨床特點%危險因素
간난사균%간난사균상관성복사%항생소상관성복사%림상특점%위험인소
Clostridium difficile%Clostridium diffcile-associated diarrhea%Antibiotic-associated diarrhea%Clinical characteristics%Risk factors
目的：探讨艰难梭菌相关性腹泻(CDAD)的临床特点、危险因素和防治策略，为CDAD的预防和临床诊断提供依据。方法：对2012年1-12月收集的286例抗生素相关性腹泻患者的临床资料进行前瞻性研究，分析CDAD患者的临床特点和发病的相关危险因素。结果：大多数CDAD患者均有严重的基础疾病；老年患者的发病率远高于中青年患者，且老年组患者基础疾病患病率、鼻饲、APACHEⅡ评分、腹泻持续时间、抗生素使用天数、肌酐值均较中青年组高，腹泻7 d缓解率、白蛋白值较中青年组低(P<0.05)；鼻饲、APACHEⅡ评分偏高、住院天数长、超敏C反应蛋白值高、使用抗生素时间长、多联抗生素是引起CDAD的危险因素。结论：临床上在抗感染的同时应合理使用广谱抗生素，对有危险因素的老年患者应加强预防和检测，积极治疗原发病，提高机体的免疫力，同时医院应建立系统的CDAD监测体系，当发病率明显增高、严重病例明显增多时应采取特别措施以利于CDAD的早期诊断和治疗。
目的：探討艱難梭菌相關性腹瀉(CDAD)的臨床特點、危險因素和防治策略，為CDAD的預防和臨床診斷提供依據。方法：對2012年1-12月收集的286例抗生素相關性腹瀉患者的臨床資料進行前瞻性研究，分析CDAD患者的臨床特點和髮病的相關危險因素。結果：大多數CDAD患者均有嚴重的基礎疾病；老年患者的髮病率遠高于中青年患者，且老年組患者基礎疾病患病率、鼻飼、APACHEⅡ評分、腹瀉持續時間、抗生素使用天數、肌酐值均較中青年組高，腹瀉7 d緩解率、白蛋白值較中青年組低(P<0.05)；鼻飼、APACHEⅡ評分偏高、住院天數長、超敏C反應蛋白值高、使用抗生素時間長、多聯抗生素是引起CDAD的危險因素。結論：臨床上在抗感染的同時應閤理使用廣譜抗生素，對有危險因素的老年患者應加彊預防和檢測，積極治療原髮病，提高機體的免疫力，同時醫院應建立繫統的CDAD鑑測體繫，噹髮病率明顯增高、嚴重病例明顯增多時應採取特彆措施以利于CDAD的早期診斷和治療。
목적：탐토간난사균상관성복사(CDAD)적림상특점、위험인소화방치책략，위CDAD적예방화림상진단제공의거。방법：대2012년1-12월수집적286례항생소상관성복사환자적림상자료진행전첨성연구，분석CDAD환자적림상특점화발병적상관위험인소。결과：대다수CDAD환자균유엄중적기출질병；노년환자적발병솔원고우중청년환자，차노년조환자기출질병환병솔、비사、APACHEⅡ평분、복사지속시간、항생소사용천수、기항치균교중청년조고，복사7 d완해솔、백단백치교중청년조저(P<0.05)；비사、APACHEⅡ평분편고、주원천수장、초민C반응단백치고、사용항생소시간장、다련항생소시인기CDAD적위험인소。결론：림상상재항감염적동시응합리사용엄보항생소，대유위험인소적노년환자응가강예방화검측，적겁치료원발병，제고궤체적면역력，동시의원응건립계통적CDAD감측체계，당발병솔명현증고、엄중병례명현증다시응채취특별조시이리우CDAD적조기진단화치료。
Objective:To investigate clostridium difficile-associated diarrhea(CDAD) of clinical characteristics,risk factors and prevention strategy,for CDAD prevention and provide basis for clinical diagnosis.Method:From January 2012 to December 2012,286 patients with antibiotics collected the clinical data of patients with cid-associated diarrhea prospective research,analysis of CDAD patients clinical characteristics and the relative risk factors.Result:Most patients with CDAD were severe basic diseases;The incidence of elderly patients with far higher than young and middle-aged patients,and old patients basic diseases prevalence, BiSi,APACHEⅡscore,diarrhea duration,antibiotics use days,creatinine values are a young and middle-aged group is high,the diarrhea 7 remission rate, albumin value is low young and middle-aged group(P<0.05);BiSi,APACHEⅡscore on the high side,be in hospital days long,super sensitive c-reactive protein value is high,the use of antibiotics for a long time,concatenated antibiotics is a cause of CDAD risk factors.Conclusion:The clinical anti-infective at the same time should be reasonable use of broad-spectrum antibiotics,there are risk factors of older patients should strengthen prevention and detection,and actively cure the primary disease and improve the body’s immunity,and at the same time,the hospital shall establish system of CDAD monitoring system,when the incidence increased obviously,severe cases should be a significant increase in special measure of CDAD for early diagnosis and treatment.
