细菌性肺炎患儿继发头孢哌酮/舒巴坦相关性腹泻临床分析  

Clinical analysis of secondary cefoperazone/sulbactam associated diarrhea in children with bacterial pneumonia

作　　者：刘勇[1] 程国平[1] 戴昕[1] 汪在华[2] 蔡萍[2] 张振[2] 

机构地区：[1]湖北省咸宁市通城县人民医院儿科,437400 [2]武汉市妇女儿童医疗保健中心

出　　处：《中国实用医药》2015年第10期6-8,共3页China Practical Medicine

基　　金：武汉市卫计委临床医学科研基金项目(项目编号:WX13A12)

摘　　要：目的探讨细菌性肺炎患儿继发头孢哌酮/舒巴坦相关性腹泻的相关因素及预后。方法分析376例使用过头孢哌酮/舒巴坦患儿的年龄、性别、白细胞数、中性粒细胞数、C反应蛋白(CRP)、难辨梭状芽孢杆菌(CD)、抗生素使用时间和住院时间,发生抗生素相关性腹泻(AAD)的患儿第一次腹泻开始时间、腹泻时间、腹泻次数、服用益生菌时间、腹泻治疗药物情况。结果 376例使用过头孢哌酮/舒巴坦的细菌性肺炎患儿中发生AAD 122例。发生与未发生AAD患儿相比年龄、头孢哌酮/舒巴坦使用时间和住院时间比较,差异具有统计学意义(P<0.01)。AAD患儿中轻型和重型分别为73、49例,重型AAD患儿CD阳性率与无腹泻患儿相比差异具有统计学意义(P<0.05)。122例AAD患儿治疗后有17例复发腹泻,复发与未复发AAD患儿大便CD阳性数、腹泻时间、服用益生菌时间、抗生素使用时间和住院时间差异具有统计学意义(P<0.05)。结论细菌性肺炎患儿使用头孢哌酮/舒巴坦治疗后AAD发病率较高,重型AAD患儿CD阳性率高,复发AAD患儿抗生素使用时间和住院时间更长。Objective To investigate the related factors and prognosis of secondary cefoperazone/sulbactam associated diarrhea in children with bacterial pneumonia.Methods Analysis was made on age, gender, white blood cell count, neutrophile granulocyte count, C-reactive protein （CRP）, clostridium difficile （CD）, antibiotics use time, and hospital stay of 376 children who took cefoperazone/sulbactam. For those who had antibiotic associated diarrhea （AAD）, summarization was also made on their first diarrhea start time, diarrhea last time, diarrhea times, probiotics use time, and diarrhea drugs.Results Among 376 children with bacterial pneumonia who took cefoperazone/sulbactam, there were 122 cases of them had AAD. The difference of age, gender, use time of cefoperazone/sulbactam, and hospital stay between children with AAD and those without AAD had statistical significance （P〈0.01）. Among children with AAD, 73 of them had mild symptom, and 49 had severe symptom. The difference of CD positive rate between severe AAD children and children without AAD had statistical significance （P〈0.05）. After treatment, there were 17 cases with recurrent diarrhea among 122 AAD children. There were statistically significant differences between relapse AAD children and non-relapse children of CD positive rate, diarrhea time, probiotics use time, antibiotics use time and hospital stays （P〈0.05）. Conclusion AAD morbidity is high due to cefoperazone/sulbactam treatment for children with bacterial pneumonia. Severe AAD children have high CD positive rate, and relapse AAD children have long antibiotics use time and hospital stay.

关 键 词：抗生素相关性腹泻 头孢哌酮/舒巴坦 细菌性肺炎 患儿 

分 类 号：R725.6[医药卫生—儿科]