伪膜性肠炎26例临床诊治分析

Clinical Analysis of 26 Cases of Pseudomembranous Colitis

目的:分析伪膜性肠炎(pseudom enbraneouscolitis PME)的临床特点、内镜下表现、病理特点及诊治要点,以提高对该病的认识。方法:回顾性分析冠县人民医院消化内科2005年2月-2010年7月收治的26例PME患者的临床资料,对病史、临床表现、实验室结果、内镜结果及治疗情况汇总分析。结果:26例患者大多数在使用广谱抗生素尤其是头孢菌素的过程中出现腹泻、腹痛及发热等表现,少部分发生在外科手术、恶性肿瘤的患者。结论:PME多在应用广谱抗生素或有基础疾病的患者中发病,体质衰弱、外科重大手术、恶性肿瘤患者等为易感人群。根据抗生素应用史、易患人群、典型临床表现、内镜下典型表现及必要的实验室检查多可明确诊断。停用原来应用的抗生素,给予甲硝唑、万古霉素以及对症支持治疗多可获得满意效果。

Objective： To analysis of pseudomembranous colitis （ pseudomenbraneouscolitis PME ） of the clinical features, endoscopic findings, pathological features and diagnosis and treatment, to raise awareness of the disease.Method： A retrospective analysis of Guanxian people＇s hospital in 2005 Febrnary-2010 July department of internal medicine 26 cases chnical data of PME, on the history, clinical presentation, laboratory findings, endoscopic findings and treatment of meta-analysis.Result： In 26 patients most in use of broad-spectrum antibiotics, especially cephalosporins during diarrhea, abdominal pain and fever and other performance, little part in surgical operation, the patients with malignant tumor.Conclusion： PME in the application of broad-spectrum antibiotics or underlying diseases of the patients the onset, physical weakness, surgery, major operation in patients with malignant tumor for the susceptible population.According to the application of antibiotics, susceptible population history, typical clinical presentation, endoscopic typical manifestation and laboratory examinations necessary more definitive diagnosis.Deactivate the original application of antibiotic vancomycin and metranidazole, give, symptomatic treatment, much can get satisfactory results.