摘要
目的:探讨艰难梭菌相关性腹泻(CDAD)的临床特点、危险因素和防治策略,为CDAD的预防和临床诊断提供依据。方法:对2012年1-12月收集的286例抗生素相关性腹泻患者的临床资料进行前瞻性研究,分析CDAD患者的临床特点和发病的相关危险因素。结果:大多数CDAD患者均有严重的基础疾病;老年患者的发病率远高于中青年患者,且老年组患者基础疾病患病率、鼻饲、APACHEⅡ评分、腹泻持续时间、抗生素使用天数、肌酐值均较中青年组高,腹泻7 d缓解率、白蛋白值较中青年组低(P<0.05);鼻饲、APACHEⅡ评分偏高、住院天数长、超敏C反应蛋白值高、使用抗生素时间长、多联抗生素是引起CDAD的危险因素。结论:临床上在抗感染的同时应合理使用广谱抗生素,对有危险因素的老年患者应加强预防和检测,积极治疗原发病,提高机体的免疫力,同时医院应建立系统的CDAD监测体系,当发病率明显增高、严重病例明显增多时应采取特别措施以利于CDAD的早期诊断和治疗。
Objective：To investigate clostridium difficile-associated diarrhea（CDAD） of clinical characteristics,risk factors and prevention strategy,for CDAD prevention and provide basis for clinical diagnosis.Method：From January 2012 to December 2012,286 patients with antibiotics collected the clinical data of patients with cid-associated diarrhea prospective research,analysis of CDAD patients clinical characteristics and the relative risk factors.Result：Most patients with CDAD were severe basic diseases;The incidence of elderly patients with far higher than young and middle-aged patients,and old patients basic diseases prevalence, BiSi,APACHEⅡscore,diarrhea duration,antibiotics use days,creatinine values are a young and middle-aged group is high,the diarrhea 7 remission rate, albumin value is low young and middle-aged group（P〈0.05）;BiSi,APACHEⅡscore on the high side,be in hospital days long,super sensitive c-reactive protein value is high,the use of antibiotics for a long time,concatenated antibiotics is a cause of CDAD risk factors.Conclusion：The clinical anti-infective at the same time should be reasonable use of broad-spectrum antibiotics,there are risk factors of older patients should strengthen prevention and detection,and actively cure the primary disease and improve the body’s immunity,and at the same time,the hospital shall establish system of CDAD monitoring system,when the incidence increased obviously,severe cases should be a significant increase in special measure of CDAD for early diagnosis and treatment.
出处
《中外医学研究》
2013年第25期1-3,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
艰难梭菌
艰难梭菌相关性腹泻
抗生素相关性腹泻
临床特点
危险因素
Clostridium difficile
Clostridium diffcile-associated diarrhea
Antibiotic-associated diarrhea
Clinical characteristics
Risk factors
