外科危重患者与抗生素相关性腹泻  

Antibiotic Associated Diarrhea in Surgical Critically Patients

作　　者：赵松[1] 李文雄[1] 陈惠德[1] 李有信[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院,北京100027

出　　处：《中华医院感染学杂志》2001年第3期161-162,共2页Chinese Journal of Nosocomiology

摘　　要：目的　探讨外科危重患者抗生素相关性腹泻 (AAD)的主要危险因素及其预防和治疗措施。方法　调查我院 SICU近 3年来 2 44例重症患者 AAD的发病情况 ,分析禁食、腹部手术、疾病的严重程度与 AAD的关系。并评价一些治疗方法与相应的治疗效果。结果　 35例患者发生 AAD,发生 AAD前均使用高级广谱抗生素 ;禁食、腹部手术后、APA- 评分高者 AAD发生率均相应高于进食、非腹部手术、APA- 评分低的患者。结论　合理使用抗生素 ,积极使用胃肠道途径是预防 SICU患者发生 AAD的有力措施 ;发生 AAD后 ,应采取有效的隔离措施 ,尽可能改用诱发 AAD率低的抗生素 ,正常人大便混悬液保留灌肠是治疗OBJECTIVE To evaluate the main risk factors of the antibiotic associated diarrhea(AAD)in surgical critically ill patients and their preventive and therapeutic measures. METHODS To investigate morbidity of AAD in our SICU 244 cases during last three years, to analyse the relationship between AAD and fasting,surgery,seriousness of diseases(we estimate the seriousness of diseases by APA Ⅱ scoring)and to evaluate some therapeutic methods with their corresponding therapeutic results. RUSULTS Thirty five patients result in AAD, all of them have received extending spectrum antibiotics before developing to be AAD.Patients with fasting,abdominal surgery and high APA Ⅱ scores result in higher AAD than that without them and with low APA Ⅱ scores. CONCLUSIONS It is an efficient measure to prevent patients from AAD for using antibiotics reasonably and utilizing the gastrointestinal tract actively.Patients with AAD should be isolated and used antibiotics for the lower induced AAD as possible as we can, clysis with feces solution of healthy person is good for curing AAD.

关 键 词：外科 重症监护室 抗生素相关性腹泻 

分 类 号：R613[医药卫生—外科学] R595.3[医药卫生—临床医学]