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目的:探讨住院患儿抗生素相关性腹泻(AAD)的临床特点及预防对策。方法:回顾性分析2012年1月至2012年12月应用抗生素治疗的820例患儿的临床资料,观察AAD的发生情况、临床表现、导致AAD发生的相关因素、AAD处理及预后。结果:发生AAD共60例(7.32%),AAD发生时平均应用抗生素(5.47±3.02)d;抗生素使用剂量均按照说明书应用;引起AAD的抗生素依次为:头孢菌素、青霉素、碳青霉烯类、大环内酯类。AAD组患儿禁食、应用抗生素种数及时间、实施侵袭性操作与无AAD组比较差异有统计学意义(P<0.05),两组年龄、预防应用抗生素情况比较差异无统计学意义;AAD组治疗以后腹泻停止时间平均(5.85±2.87)d;AAD组病死率8.33%,高于无AAD组的1.32%(P<0.05);AAD组住院时间(23.76±6.45)d,长于无AAD组的(13.21±3.17)d(P<0.05)。结论:住院患儿AAD发生率较高,影响因素复杂,虽多为单纯性腹泻经过治疗缓解,但延长了住院时间,增加病死率,应积极防治AAD。
Objective: To investigate the clinical features and preventive measures of antibiotic-associated diarrhea (AAD) in hospitalized children. Methods: The clinical data of 820 children treated with antibiotics from January 2012 to December 2012 were retrospectively analyzed. The incidence of AAD, clinical manifestations, related factors leading to AAD, AAD treatment and prognosis were observed. Results: The incidence of AAD was 60 cases (7.32%), the average time of AAD was 5.47 ± 3.02 days. The dosage of antibiotics was used in accordance with the instructions. The antibiotics of AAD were cephalosporin, penicillin, carbapenem Classes, macrolides. AAD group of children fasting, the number of antibiotics and the time of application, the implementation of aggressive operation and no AAD group was statistically significant (P <0.05), two groups of age, prevention and control of antibiotics compared with no significant difference; AAD The average time to stop diarrhea after treatment was 5.85 ± 2.87 days. The mortality rate in AAD group was 8.33%, which was significantly higher than that in AAD group (1.32%, P <0.05). The length of hospital stay in AAD group was (23.76 ± 6.45) days, (13.21 ± 3.17) d (P <0.05). Conclusions: The incidence of AAD in hospitalized children is high and the influencing factors are complex. Although simple diarrhea may be alleviated after treatment, the hospital stay is prolonged and the mortality rate is increased. AAD should be actively controlled.