抗生素相关性伪膜性肠炎的临床及内镜特点  

Clinical features and endoscopic findings of antibiotic-associated pseudomanbranous colonitis

作　　者：黄开红[1] 李楚强[1] 陈为宪[1] 王连源[1] 陈其奎[1] 夏忠胜[1] 朱兆华[1] 

机构地区：[1]中山大学附属第二医院消化内科,广东广州510120

出　　处：《中国内镜杂志》2007年第8期854-856,共3页China Journal of Endoscopy

摘　　要：目的通过对抗生素所致伪膜性肠炎(pseudomembranous colitis,PMC)的分析,总结临床经验教训,提高诊治水平。方法对该院1994～2005年73例临床使用抗生素引起的PMC患者从年龄、合并疾病、抗生素的使用种类、时间、发病时间及治疗方法等方面进行回顾性总结及分析。结果PMC多发于合并有长期慢性疾病、年龄大、体质差、手术后及抗生素应用不规范的老年患者。结论抗生素应用不合理是引发PMC的主要原因,对长期大量使用抗生素的老年患者出现腹痛、腹泻时,结合结肠镜的特征表现首先应考虑有无PMC,及早停用抗生素,使用足量和足疗程的甲硝唑和万古霉素是治疗PMC有效方法。[Objective] To analyze the clinical and endoscopic features of antibiotic-associated pseudomembranous colitis, and summarize clinical lessons, in order to improve the level of diagnosis and treatment. [Method] The clinical data of 73 patients with antibiotic-associated pseudomembranous colitis in the Second Affiliated Hospital of Sun Yat-sen University from 1994 to 2005 was analyzed retrospectively according to their respective ages, complications, the types of antibiotics, time of onset and treatments, et al. [Results] Pseudomembranous colitis was a common gastrointestinal complication in old patients with chronic diseases, old age, weak constitution, postoperation and antibiotic abusing. [Conclusion] Antibiot/c abusing is the main cause of pneudomembranous colitis. Most of the symptoms in the old patients treated with superfluous antibiotics were exhibited as abdominal pain, watery diarrhea. The diagnosis can be confirmed by the sigmoidoscopic features, and it would be treated successfully with oral Vancomycin ＆ Metronidazole rationally after withdrawal of antibiotics promptly.

关 键 词：伪膜性肠炎 临床特点 结肠镜检查 抗生素 

分 类 号：R516.1[医药卫生—内科学]