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目的探讨重症医学科(ICU)抗生素相关性腹泻(AAD)患者的临床特点及其应用中西医结合治疗的临床疗效。方法选取赣州市人民医院重症医学科2014—2015年收治的AAD患者92例,根据抽签法将所有患者分为对照组和观察组,各46例。对照组患者采用单纯西医治疗,连续治疗2周;观察组患者采用中西医结合治疗,连续治疗1周。统计抗生素使用情况及临床症状,比较两组患者的临床疗效。结果在所有患者中,服用头孢三代抗生素患者AAD发生率最高,其次为青霉素、碳青霉烯、头孢二代及克林霉素。AAD患者主要粪便类型为稀水泡沫样便,其次为黏液样便、黏膜脱落坏死。观察组患者治疗总有效率高于对照组(P<0.05)。结论服用头孢三代抗生素患者AAD发生风险较大,且AAD患者多为稀水泡沫样便,中西医结合治疗ICU AAD患者的临床疗效确切。
Objective To investigate the clinical features of patients with antibiotic-associated diarrhea (AAD) in intensive care unit (ICU) and its clinical efficacy in the treatment of Integrative Chinese and Western medicine. Methods Ninety-two patients with AAD admitted to the Department of Critical Care Medicine of Ganzhou People’s Hospital from 2014 to 2015 were selected and randomly divided into control group and observation group according to the method of lottery. Patients in the control group were treated with Western medicine only for 2 weeks. The patients in the observation group were treated with combination of TCM and Western medicine for 1 week. Statistical antibiotic use and clinical symptoms, clinical efficacy of two groups were compared. Results In all patients, the incidence of AAD was the highest among patients taking ceftriaxone antibiotics, followed by penicillin, carbapenem, cephalosporin II and clindamycin. The main types of faecal AAD patients were watery foamy stools, followed by mucoid stools, mucosal shedding and necrosis. The total effective rate of observation group was higher than that of control group (P <0.05). Conclusions AAD patients taking ceftriaxone have a higher risk of AAD. Most of patients with AAD are lather foamy stools. The clinical efficacy of combined traditional Chinese and western medicine in the treatment of patients with AAD in ICU is definite.