28例伪膜性肠炎临床分析  

Clinical characteristic of 28 cases of pseudomembranous colonitis

作　　者：李承恩[1] 欧希龙[2] 贺永军[1] 宋丽华[1] 曹大中[2] 俞谦[2] 俞婷[2] 张有珍[2] 吴自英[2] 

机构地区：[1]句容市人民医院消化科,江苏句容212400 [2]东南大学附属中大医院消化科,江苏南京210009

出　　处：《东南大学学报（医学版）》2011年第6期921-923,共3页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨伪膜性肠炎(PMC)的临床表现、高危因素、内镜特征、诊断及治疗。方法:回顾性分析我院消化科和东南大学附属中大医院消化科2003年3月至2009年11月诊治的28例PMC患者的临床资料。结果:全部患者均在使用广谱抗生素过程中出现腹泻。老年人、住院时间长、术后、使用广谱抗生素及抗生素使用时间长是PMC的高危因素。肠镜有特征性表现。所有患者停用抗生素,用甲硝唑、万古霉素、去甲万古霉素后全部治愈,万古霉素和去甲万古霉素疗效明显优于甲硝唑。结论:PMC常在应用抗生素后发病,老年人、重症患者及外科大手术患者在临床抗感染治疗过程中出现腹泻要考虑PMC,万古霉素、去甲万古霉素是首选药物。Objective： To explore the clinical mansifestations,endoscopic feature,high risk factors,diagnosis and the therapy of the pseudomembranous colonitis.Methods： The clinical data of 28 cases were retrospectively analysed.Results： All the patients appeared diarrhoea after broad-spectrum antibiotics was used.Advanced age,broad-antibiotic therapy,antibiotic therapy time delayed,hospital stay delayed,number of antibiotics used more than one,post-operative procedures were the important clinical risk factors.The colon endoscope appeares the feature of pseudomembranous colonitis.All the patients were cured by taking metronidazole,vancomvcin or norvancomycin,after stopping using antibiotics.Vancomvcin and norvancomycin were more effective than metronidazole.Conclusion： Pseudomembranous colonitis is correlative with antibiotics.The pseudomembranous colitis should be first suspected in cases with presumed antibiotic-associated diarrhea having such the risk factors.The cure rate for metronidazole remain low.The best therapy is vancomvcin and norvancomycin.

关 键 词：伪膜性肠炎 抗生素 诊断和治疗 难辨梭状芽孢杆菌 

分 类 号：R574[医药卫生—消化系统]