中国实用外科杂志

中国实用外科杂志

• 专题笔谈 • 上一篇    下一篇

抗生素相关腹泻识别与处理

朱承睿，马晓春   

  1. 中国医科大学附属第一医院重症医学科，辽宁沈阳 110001
  • 出版日期:2016-02-01 发布日期:2016-01-29

  • Online:2016-02-01 Published:2016-01-29

摘要：

抗生素相关腹泻（AAD）为抗生素应用的重要并发症，可分为感染性AAD及非感染性AAD。感染性AAD最常见的病原菌为艰难梭菌，其临床表现严重，并可引起伪膜性肠炎。非感染性AAD为临床常见的AAD类型，临床症状轻。AAD的首要治疗为调整或停用抗生素，并可联用菌群调节剂等，对于怀疑为感染性AAD者，可经验性给予肠道内应用万古霉素或甲硝唑治疗。合理的抗生素、微生态制剂的使用是预防AAD的有效措施。

关键词: 抗生素相关腹泻, 腹泻, 艰难梭菌, 伪膜性肠炎

Abstract:

Recognition and management of antibiotic-associated diarrhea        ZHU Cheng-rui，MA Xiao-chun. Intensive Care Unit，the First Affiliated Hospital of China Medical University，Shenyang110001，China
Corresponding author：MA Xiao-chun，E-mail：xcma2972@
sina.com
Abstract    Antibiotic-associated diarrhea （AAD） is an important complication of antibiotic use，which can be divided into infective type and non-infective type. The most common pathogenic bacteria of the infective AAD is clostridium difficile，which has serious clinical manifestations，and can cause pseudomembranous colitis. Non-infective AAD is the most frequent pattern of AAD. The discontinuation and replacement of the inciting antibiotics can be effective for most AAD, and intestinal flora regulation should be used. Empiric therapy of enteral administration of vancomycin or metronidazole should be used for infective AAD. Rational use of antibiotics and the use of probiotics are effective measures for the prevention of AAD.

Key words: antibiotic-associated diarrhea, diarrhea, clostridium difficile, pseudomembranous colitis