重症颅脑外伤患者抗生素相关性肠炎的疾病负担

目的:分析重症颅脑外伤患者发生抗生素相关性肠炎(AAC)的疾病负担,并探讨其预防和治疗对策。方法:回顾性分析157例重症颅脑外伤患者发生AAC与抗菌药物应用时间、剂量、种类的关系。结果:抗菌药物超量应用与AAC发生密切相关(P<0.01),以应用头孢菌素类为最高;而发生了AAC的重症颅脑外伤患者使用抗菌药物平均时间为(24.6±5.0)d,未发生AAC的重症颅脑外伤患者使用抗菌药物平均时间为(11.4±7.8)d,抗菌药物使用时间长短与AAC发生密切相关(P<0.01);不合理使用抗菌药物的发生率与AAC发生密切相关(P<0.01);观察组住院总费用为(73541±46724)元,对照组住院总费用为(38579±28572)元,其中药费观察组为(17824±21324)元,对照组为(9856±9547)元,2组的住院总费用、药费的差异均有统计学意义(P<0.01或P<0.05)。结论:重症颅脑外伤患者AAC有较大的疾病负担。预防重症颅脑外伤患者发生AAC的关键在于综合治疗,特别是广谱抗菌药物的合理应用。

Disease Burden of Antibiotic Associated Colitis in Patients with Severe Traumatic Brain Injury

OBJECTIVE：To analyze disease burden of antibiotic associated colitis（AAC）in patients with severe traumatic brain injury,and to explore prevention and treatment countermeasures. METHODS：Retrospective analysis method was used to analyze the relationship between the occurrence of AAC in 157 cases of severe traumatic brain injury and application duration,dosage and category of antibiotics. RESULTS：Overuse of antibiotics was closely associated with the occurrence of AAC,especially cephalosporins（P0.01）. Average application duration of antibiotics in AAC patient with severe traumatic brain injury was（24.6±5.0） d,and that in severe traumatic brain injury patient without AAC was（11.4±7.8）d. Application duration of antibiotics was closely related to the occurrence of AAC（P0.01）. The incidence of irrational application of antibiotics was closely associated with the occurrence of AAC（P0.01）. Total hospitalization cost of observation group was（73 541±46 724）yuan,and that of control group was（38 579±28 572）yuan. Drug cost of observation group was（17 824±21 324） yuan and that of control group was（9 856± 9 547）yuan. There were statistical significance in difference of total hospitalization cost and drug cost between two groups（P 0.01 or P0.05）. CONCLUSIONS：It is important to strengthen prevention and comprehensive treatment in AAC patients with severe traumatic brain injury,especially broad spectrum antibiotics. There is big disease burden in AAC patients with severe traumatic brain injury.