肠道菌群失调233例临床分析

Clinical Analysis of 233 Cases with Intestinal Dysbacteriosis

目的 探讨临床发生抗生素相关菌群失调的主要原因度其有效预防措施。方法 采用回顾性研究的调查方法，了解233例患者者年龄、抗生素使用与肠道菌群失调的关系。结果腹泻是肠道菌群失调的主要症状，老年人（〉60岁）123例（54．2％）。其中Ⅰ度44例（18．9％）；Ⅱ度134例（61．8％）；Ⅲ度55例（23．6％）。大便常规检查54％患者正常，46％患者大便检查异常。195患者有应用抗生素史，使用1种抗生素的45例，使用2种抗生素的122例，使用3种抗生素的21例，使用4种抗生素的7例，发生菌群失调在使用抗生素后3～21d，平均（9．8±5．6）d，15例伪膜性肠炎患者中3例应用2种，11例应用3种或3种以上抗生素超过14d。结论 老年人、多种抗生素联合使用、长期用药以及使用疗效高的广谱抗生素都是连续发生菌群失调的主要原因，同时应用活菌制剂及益生元，可能有利于增加有益菌群，调整菌群失调，增强肠道抗感染能力。

Objective To approach the main causes and the effective preventive measures of clinical antibiotics-correlated intestinal dysbacteriosis. Methods Retrospective study was used to analyse the relationships among the age of the patients,the use of antibiotics and intestinal dysbacteriosis. Results The cardinal symptom of intestinal dysbacteriosis was diarrhea. The aged（ 〉 60 ages） occupies 54.2% （ 123 cases）. There are 44 cases of degree Ⅰ （ 18.9% ） ,134 cases of degree Ⅱ （61.8%） and 55 cases of degree m （23.6%）. The stool routine examination result was that 54% of patients was normal,while 46% was abnormal. There are 195 patients were treated with antibiotics,45 patients were treated with one kind of antibiotic, 122 patients were two kinds,21 patients were 3 kinds and only 7 patients were 4 kinds. The symptoms of intestinal dysbacteriosis happened in 3 - 21 days after the use of the antibiotics （9.8 ± 5.6 days in average）. In 15 patients with pseudomembranous enterocolitis, there were 3 patients were treated with two kinds of antibiotics, while 11 patients using three or more, the course was more than 14 days. Conclusions The main causes of intestinal dysbacteriosis consist of the age,combined use of antibiotics,long-term use of antibiotics and the use of broad-spectrum antibiotic. Microecology praeparatum and probiotics is profit to augment beneficial flora, adjust dysbacteria and enhance the capability of anti-infection in intestinal tract.