摘要
背景:由于抗生素的广泛应用,伪膜性肠炎的发病率逐渐增加。目的:总结伪膜性肠炎患者的内镜表现和临床诊治过程,提高该病的鉴别诊断和治疗水平。方法:对2006年10月～2007年12月北京友谊医院确诊的伪膜性肠炎患者进行回顾性分析。结果:共21例患者纳入分析。12例临床表现为稀水便,9例为黏液血便。3例粪便培养球菌/杆菌比例倒置。17例内镜下表现为黏膜上散在黄色或白色椭圆形隆起:4例为黏膜上附着大片状黄褐色伪膜,伴糜烂、溃疡。确诊后所有患者均停用抗生素。10例患者仅使用微生态制剂治疗,11例在上述基础上加用甲硝唑或万古霉素。经治疗后所用患者腹泻均缓解。结论:伪膜性肠炎的临床表现除稀水便外,还可能出现黏液血便,内镜表现有特征性,对诊断具有重要意义。停用抗生素、使用微生态制剂和甲硝唑或万古霉素对伪膜性肠炎的治疗有效。
Background： The prevalence of pseudomembranous enterocolitis has increased rapidly because of the widespread use of antibiotics. Aims： To summarize the endoscopic features and management of pseudomembranous enterocolitis, so as to improve the differential diagnosis and therapy of this disease. Methods： Patients showed evidence of pseudomembranous enterocolitis in Beijing Friendship Hospital from Oct. 2006 to Dee. 2007 were analyzed retrospectively. Results： Twentyone patients were enrolled in the analysis. Among them, 12 presented with watery stool, and 9 with mucous bloody stool. Stool culture revealed inversion of coccus/bacillus ratio in 3 patients. The endoscopic features in 17 patients were scattered white or yellow bulged oval plaques on the mucosa, and in other patients with more severe disease were yellowish-brown pseudomembrane covered mueosa with erosion and ulcer. All patients discontinued the antibiotic treatment. Ten patients took probiotics only, while 11 took metronidazole or vancomycin in addition. Diarrhea was relieved after treatment in all patients. Conclusions： Pseudomembranous enterocolitis manifests not only watery stool, but also mucous bloody stool. The endoscopic feature is characteristic for the disease and is important for its diagnosis. Discontinuing antibiotic treatment and giving probiotics, metronidazole or vancomyein are effective for its treatment.
出处
《胃肠病学》
2009年第7期397-399,共3页
Chinese Journal of Gastroenterology
关键词
小肠结肠炎
伪膜性
内镜检查
诊断
治疗
回顾性研究
Enteroeolitis, Pseudomembranous
Endoscopy
Diagnosis
Therapy
Retrospective Studies
