神经重症患者抗生素相关性腹泻的临床分析

发布时间：2018-03-16 16:14

本文选题：神经重症　切入点：抗生素相关性腹泻　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析我院神经重症监护室患者抗生素相关性腹泻的临床特点及治疗效果,为神经重症监护室患者合理使用抗生素提供依据。方法:对青岛大学医学院附属医院神经重症监护室2014年1月~2016年6月收治的无胃肠道利用等禁忌证神经重症患者260例进行回顾性统计分析。分析使用抗生素对患者肠道菌群的影响,同时比较抗生素使用的剂量、使用时间及联合用药对肠道菌群失调的影响,比较不同治疗方法对胃肠道功能恢复的治疗效果。结果:1.我院神经重症监护室抗生素相关性腹泻的发生率为29.2%。2.发生抗生素相关腹泻的患者总体年龄偏大,APACHE评分高,住院天数更长,血清白蛋白数值低,并且其差异均具有统计学意义(p0.05)。3.使用抗生素患者肠道菌群失调率显著高于未使用抗生素患者(分别为36.5%、11.5%),差异具有统计学意义(p0.05)。4、肠道菌群失调发生率与抗生素使用的时间、剂量及联合应用的种类呈正相关,差异均具有统计学意义(p0.05)。5、对肠道菌群失调患者76例分别采用三种不同治疗方法,发现停用抗生素并应用益生菌或万古霉素治疗组与单独停用抗生素组比较,其胃肠道功能改善情况更明显,且差异具有统计学意义(p0.05)。结论:神经重症监护室患者抗生素相关性腹泻发生率较高,且与抗生素使用的剂量、时间及联合种类有关。及时诊断、停用抗生素、口服益生菌或万古霉素是治疗的重要措施。
[Abstract]:Objective: to analyze the clinical characteristics and therapeutic effect of antibiotic associated diarrhea in patients with neurologic intensive care unit (NICU) in our hospital. Methods: to provide evidence for rational use of antibiotics in patients with neurologic intensive care unit (NICU). Methods: patients with severe neurological diseases without contraindications such as gastrointestinal utilization were treated in Neurointensive Care Unit, affiliated Hospital of Qingdao University Medical College from January 2014 to June 2016. The influence of antibiotics on intestinal flora of patients was analyzed retrospectively. At the same time, the effects of dosage, time and combination of antibiotics on intestinal flora disorder were compared. Results 1. The incidence of antibiotic associated diarrhea in neurointensive care unit was 29.2.2.The patients with antibiotic associated diarrhea had higher Apache score. The length of stay in hospital is longer and the value of serum albumin is low. And the difference was statistically significant (P 0.05). The intestinal flora imbalance rate in patients with antibiotics was significantly higher than that in patients without antibiotics (36.5%). The difference was statistically significant (p 0.05 路4). The incidence of intestinal flora disorders and the time of antibiotic use were significantly higher than those of patients without antibiotics. There was a positive correlation between the dosage and the type of combined use, and the difference was statistically significant (P 0.05). 76 patients with intestinal dysbacteriosis were treated with three different methods. The results showed that the improvement of gastrointestinal function was more obvious in the probiotic or vancomycin group than in the control group. Conclusion: the incidence of antibiotic associated diarrhea in patients in neurointensive care unit is high, and it is related to the dosage, time and combination of antibiotics. Oral probiotics or vancomycin is an important measure of treatment.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7

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