住院患儿抗生素相关性腹泻临床特征分析

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。

Clinical Characteristics of Hospitalized Children with Antibiotic-Associated Diarrhea

Objective： To understand the clinical characteristics of antibiotic-associated diarrhea （AAD）, and to improve the diagnosis and treatment level. Methods ： Clinical data of 820 cases of antibiotic-associated diarrhea （ AAD ） were analyzed retrospectively. Observe the occurrence, clinical manifestation, related factors, treatment and prognosis of AAD. Results： A total of 60 cases occurred AAD （7.32%） , the time of using antibiotics was （5.47 ±3.02） days on average ; the antibiotic doses were applied in accordance with the instructions. Diarrhea caused by cephalosporin, penicillin, carbapenems, macrolides. There were significant differences between the AAD groups and the non-AAD group in fasting, antibiotics type, the time of application antibiotics, the implementation of non-invasive operation（P〈0.05）. There was no significant difference between the two groups in antibiotic prophylaxis and age （P〉0.05）. The mortality of AAD group was 8.33% , which was higher than that of non-AAD group （ 1.32% ） （P〈0.05） ; duration of diarrhea in AAD group was （5.85±2.87） days. The length of hospitalization of the two groups were （23.76±6.45） days and （ 13.21 ±3.17 ） days, respectively; the difference between the two groups was statistically significant （P〈0.05）. Conclusion： The incidence of AAD was higher in hospitalized pediatric patients. The occurrence of AAD has complicated factors. AAD can prolong hospital stay, increase mortality. ADD should be active prevented and cured.