中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2013年
7期
523-525
,共3页
甘惠中%查正伟%彭琼
甘惠中%查正偉%彭瓊
감혜중%사정위%팽경
小肠结肠炎, 伪膜性%抗菌药%腹水%内窥镜检查, 消化系统
小腸結腸炎, 偽膜性%抗菌藥%腹水%內窺鏡檢查, 消化繫統
소장결장염, 위막성%항균약%복수%내규경검사, 소화계통
enterocolitis,pseudomembranous%anti-bacterial agents%ascites%endoscopy,digestive system
目的分析中老年患者假膜性肠炎（PMC）的临床特征，提高临床对PMC的认识及诊治水平。方法回顾性分析合肥市第一人民医院2008年5月至2012年3月收治的17例PMC患者的临床资料。结果17例PMC住院患者平均年龄65岁，均存在基础疾病。患者均在使用抗生素过程中出现腹泻并伴有不同程度的腹痛等症状，其中4例合并腹水。15例联合使用两种及以上抗生素。肠镜多有典型的假膜样改变。经停用抗生素，使用甲硝唑、益生菌等治疗，14例好转出院。结论应重视存在免疫力低下原发病的中老年患者使用抗生素时PMC的诊断；除腹泻、腹痛等症状外，腹水可能是PMC的临床特征之一；粪便涂片联合结肠镜检查有益PMC的诊断；及时停用抗生素，联合甲硝唑或万古霉素及益生菌是治疗PMC的主要方法。
目的分析中老年患者假膜性腸炎（PMC）的臨床特徵，提高臨床對PMC的認識及診治水平。方法迴顧性分析閤肥市第一人民醫院2008年5月至2012年3月收治的17例PMC患者的臨床資料。結果17例PMC住院患者平均年齡65歲，均存在基礎疾病。患者均在使用抗生素過程中齣現腹瀉併伴有不同程度的腹痛等癥狀，其中4例閤併腹水。15例聯閤使用兩種及以上抗生素。腸鏡多有典型的假膜樣改變。經停用抗生素，使用甲硝唑、益生菌等治療，14例好轉齣院。結論應重視存在免疫力低下原髮病的中老年患者使用抗生素時PMC的診斷；除腹瀉、腹痛等癥狀外，腹水可能是PMC的臨床特徵之一；糞便塗片聯閤結腸鏡檢查有益PMC的診斷；及時停用抗生素，聯閤甲硝唑或萬古黴素及益生菌是治療PMC的主要方法。
목적분석중노년환자가막성장염（PMC）적림상특정，제고림상대PMC적인식급진치수평。방법회고성분석합비시제일인민의원2008년5월지2012년3월수치적17례PMC환자적림상자료。결과17례PMC주원환자평균년령65세，균존재기출질병。환자균재사용항생소과정중출현복사병반유불동정도적복통등증상，기중4례합병복수。15례연합사용량충급이상항생소。장경다유전형적가막양개변。경정용항생소，사용갑초서、익생균등치료，14례호전출원。결론응중시존재면역력저하원발병적중노년환자사용항생소시PMC적진단；제복사、복통등증상외，복수가능시PMC적림상특정지일；분편도편연합결장경검사유익PMC적진단；급시정용항생소，연합갑초서혹만고매소급익생균시치료PMC적주요방법。
Objective To analyze the clinical features of pseudomembranous colitis (PMC) in the middle-aged and elderly patients in order to improve its diagnosis and treatment. Methods The clinical data of 17 PMC inpatients diagnosed by enteroscopy in our hospital from May 2008 to March 2012 were analyzed retrospectively. Results This cohort of diagnosed patients was in an average age of 65 year, and had other diseases at the same time. They all were found diarrhea and various abdominal pains during the use of antibiotics. And 4 of them were complicated with ascites. There were 15 patients having a combined use of two or more antibiotics. Colonoscopy indicated typical pseudo membranous changes. After diagnosis, antibiotics were discontinued, and metronidazole and probiotic therapy were given. Among them, 14 cases had recovered and discharged from hospital after treatment. Conclusions Special attention should be paid to the diagnosis of PMC in middle-aged and elderly patients with primary immunocompromised diseases and continuous use of antibiotics. In addition to diarrhea, abdominal pain and other symptoms, ascites may be one of the clinical features of PMC. Fecal smear combined with colonoscopy is helpful for the diagnosis of PMC. It could be treated successfully with rationally taking of metronidazole or vancomycin and probiotic therapy after withdrawl of antibiotics as soon as possible.
