伪膜性肠炎的临床特点及内镜分析

Clinical features and endoscopic analysis of pseudomembranous colitis

目的探讨伪膜性肠炎(pseudomembranous colitis,PMC)的诱因、临床特点、结肠镜下特征、诊断及防治。方法对福建医科大学附属漳州市医院2011年1月-2015年6月收治住院的43例PMC患者进行回顾性分析。结果所有患者均出现腹泻,轻-中度患者25例、重度患者14例、复杂型4例。重度患者多为腹部及盆腔术后、肿瘤、糖尿病及高龄患者,结肠镜检查表现分类与疾病严重程度相符。所有患者停用抗生素及激素类药物,口服甲硝唑或万古霉素后,均获得治愈或好转。结论 PMC常在伴有基础疾病或高龄患者应用抗生素后出现,结肠镜检查有助于诊断、判断疾病严重程度及随访观察。

Objective To investigate the incentives,clinical features,colonoscopy characteristics,diagnosis and prevention of pseudomembranous colitis（PMC）. Methods Forty-three cases of PMC in Zhangzhou Municipal Hospital Affiliated to Fujian Medical University from Jan. 2011 to Jun. 2015 were analyzed retrospectively. Results Diarrhea occurred in all the patients. Twenty-five patients were mild to moderate,14 patients were severe,and 4 patients were complicated. Severe patients mostly occurred in patients with cancer,diabetes,advanced age,severe abdominal and pelvic surgery. The colonoscopy was consistant with the severity of disease. All the patients were cured by taking Metronidazole or Vancomycin after stopping using antibiotics and steroids. Conclusion PMC often occurs in elderly patients or patients with basic disease exposed to antibiotics. Colonoscopy is useful in the diagnosis,severity judgment and follow-up observation of PMC.