多发伤后抗生素相关性肠炎的诊断和处理

Diagnosis and treatment of antibiotic-associated colitis after multiple traumas

目的探讨多发伤并发抗生素相关性肠炎(antib iotic-assoc iated colitis,AAC)的临床特点、诊断和治疗。方法对9例多发伤并发抗生素相关性肠炎患者的临床资料及相应的诊断和治疗进行分析。结果本组病例在使用抗生素后出现腹泻,并不同程度伴有其他症状。3例行肠镜检查,病变主要累及乙状结肠和直肠,且内镜检查呈典型的病理改变。结论在多发伤抗感染治疗中应该格外谨慎,合理使用抗生素,尽可能使用诱发AAC率低的抗生素;一旦确诊,应首先使用万古霉素。

Objective To analyze the clinical characteristics,diagnosis and treatment of antibiotic-associated colitis after multiple traumas. Methods The clinical data of 9 cases with antibiotic-associated colitis after multiple traumas were investigated. Result Severe diarrhea and some other symptoms were found after the use of antibiotics. Enterescopy was performed in 3 patients,and some typical pathological changes were discovered in sigmoid colon and rectum. Conduslon Much attention should be paid to the treatment, and antibiotics should be used reasonably. The antibiotics,which show little possibility to cause antibiotic-associated colitis,should be adopted first.