外科危重患者与抗生素相关性腹泻

目的：探讨外科危重患者抗生素相关性腹泻（AAD）的主要危险因素及其预防和治疗措施。方法：调查我院SICU近3年来244例重症患者AAD的发病情况，分析禁食，腹部手术，疾病的严重程度与AAD的关系，并评价一些治疗方法与相应的治疗效果。结果：35例患者发生AAD，发生AAD前均使用高级广谱抗生素，禁食，腹部手术后，APA－Ⅱ评分高者AAD发生率均相应高于进食，非腹部手术，APA－Ⅱ评分低的患者。结论：合理使用抗生素，积极使用胃肠道途径是预防SICU患者发生AAD的有力措施，发生AAD后，应采取有效的隔离措施，尽可能改用诱发AAD率低的抗生素，正常人大便混悬液保留灌肠是治疗AAD的有效方法。

Antibiotic Associated Diarrhea in Surgical Critically Patients

OBJECTIVE To evaluate the main risk factors of the antibioticassociated diarrhea(AAD)in surgical critically ill patients and their preventive and therapeutic measures.METHODS To investigate morbidity of AAD in our SICU 244 cases during last three years,to analyse the relationship between AAD and fasting,surgery,seriousness of diseases(we estimate the seriousness of diseases by APA-Ⅱ scoring)and to evaluate some therapeutic methods with their corresponding therapeutic results.RUSULTS Thirty five patients result in AAD,all of them have received extending spectrum antibiotics before developing to be AAD.Patients with fasting,abdominal surgery and high APA-Ⅱ scores result in higher AAD than that without them and with low APA-Ⅱ scores.CONCLUSIONS It is an efficient measure to prevent patients from AAD for using antibiotics reasonably and utilizing the gastrointestinal tract actively.Patients with AAD should be isolated and used antibiotics for the lower-induced-AAD as possible as we can,clysis with feces solution of healthy person is good for curing AAD.