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目的探讨抗生素相关性腹泻(AAD)临床特点,提高临床医生对AAD的认识。方法回顾性分析2009年1月至2011年12月1 316例住院应用抗生素患者的临床资料,统计AAD发生率。把其中发生AAD的79例患者作为观察组,其余未发生AAD的1 237例患者作为对照组,统计分析79例AAD的临床症状、实验室指标、抗生素应用等治疗情况及结果,探讨影响因素。结果 AAD发生率6.00%;其中表现为单纯性腹泻65例(82.28%);大便常规、大便普通细菌培养、真菌培养多为阴性;多类抗生素均能引起AAD。79例中,77例患者治愈(97.47%),2例(2.53%)死亡。年龄大、抗生素应用种类多、时间长及应用抗酸剂、运用侵入性医疗干预措施、病重等是AAD发生的可能影响因素(P均<0.01)。结论 AAD的发生率较高,与多种因素有关,应合理使用抗生素及抗酸剂,减少侵入性操作。
Objective To investigate the clinical features of antibiotic-associated diarrhea (AAD) and to improve the understanding of AAD by clinicians. Methods The clinical data of 1 316 hospitalized patients with antibiotics from January 2009 to December 2011 were retrospectively analyzed. The incidence of AAD was calculated. A total of 79 patients with AAD were selected as the observation group and the other 1237 patients without AAD as control group. The clinical data, laboratory parameters, antibiotic application and other 79 cases of AAD were analyzed statistically to explore the influencing factors. Results The incidence of AAD was 6.00%. Among them, 65 cases were simple diarrhea (82.28%). Conventional stools and normal stool cultures were mostly negative for fungi culture. Various antibiotics could cause AAD. Of the 79 patients, 77 were cured (97.47%) and 2 (2.53%) died. Age, the variety of antibiotics used, long time and the use of antacids, the use of invasive medical interventions, severe disease and so on are the possible influencing factors of AAD (all P <0.01). Conclusions The incidence of AAD is high, which is related to many factors. Antibiotics and antacids should be used rationally to reduce the invasive operation.