摘要
目的探究急诊病房患者发生抗生素相关性腹泻(antibiotic associated diarrhea,AAD)的影响因素及益生菌应用效果。方法选取2021年3月至2022年3月本院接诊的156例于急诊科就诊患者展开研究,根据患者是否发生AAD,将其分为AAD组(n=46)和非AAD组(n=110),将AAD组患者随机分为对照组和研究组,每组均23例。Logistic回归多因素分析影响急诊病房患者发生AAD危险因素;对比研究组和对照组疗效、腹泻、轮状病毒检测情况;对比研究组和对照组治疗前、1个月后血清营养指标,包括血清白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)、血清总蛋白(total protein,TP)水平。结果Logistic回归模型分析结果显示意识状态GCS<8分、疾病感染、同种抗生素数量和联合应用抗生素是急诊科患者发生AAD发生的危险因素(P<0.05);研究组(91.30%)治疗有效率显著高于对照组(65.22%)(P<0.05);经治疗后,研究组治疗后3d腹泻次数、持续时间和腹泻总次数显著低于对照组(P<0.05);治疗1月后,研究组(13.04%)轮状病毒阳性率显著高于对照组(39.13%)(P<0.05);两组患者治疗1月后,ALB、PAB和TP表达均升高,且研究组显著高于对照组(均P<0.05)。结论对于急诊科就诊患者而言,意识状态GCS<8分、疾病感染、同种抗生素数量和联合应用抗生素是AAD发生的主要危险因素,临床应做好相应防护措施;可通过给予AAD患者相应益生菌治疗,可提升患者临床治疗效果,改善患者临床症状,值得在临床推广应用。
Objective To explore the influencing factors of antibiotic associated diarrhea(AAD)in patients from emergency ward and the effect of probiotics application.Methods A total of 156 patients admitted to the Emergency Department of our hospital from March,2021 to March,2022 were selected for this study.According to whether patients developed AAD,they were divided into the AAD group(n=46)and non-AAD group(n=110).The AAD group was randomly divided into the control group and study group,with 23 patients in each group.The risk factors of AAD in emergency ward were analyzed by logistic regression.Efficacy,diarrhea and rotavirus detection were compared between the study group and the control group.Serum nutritional indexes,including serum albumin(ALB),prealbumin(PA)and serum total protein(TP)levels,were compared between the study group and the control group before and 1 month after treatment.Results Logistic regression model analysis showed that GCS of consciousness<8 points,disease infection,number of the same antibiotics and the combined use of antibiotics were all the risk factors for AAD(P<0.05).The effective rate in the study group(91.30%)was significantly higher than that in the control group(65.22%)(P<0.05).After treatment,the number,duration and total number of diarrhea in 3d in the study group were significantly lower than those in the control group(P<0.05).After 1 month of treatment,the positive rate of rotavirus in the study group(13.04%)was significantly higher than that in the control group(39.13%)(P<0.05).After 1 month of treatment,the expressions of ALB,PAB and TP in two groups were increased,and those in the study group were significantly higher than those in the control group(ALL P<0.05).Conclusion For patients in emergency department,GCS of consciousness<8 points,disease infection,the number of homoantibiotics and the combined use of antibiotics are the main risk factors for AAD,and corresponding protective measures should be performed in clinic.Probiotics can be given to patients with AAD to improve the
作者
韩磊磊
周美佳
庞国进
关键
HAN Leilei;ZHOU Meijia;PANG Guojin;GUAN Jian(Department of Emergency,Beijing Huaxin Hospital,Beijing 100016,China;Department of Emergency Medicine,Beijing Huaxin Hospital,Beijing 100016,China)
出处
《标记免疫分析与临床》
CAS
2022年第12期2021-2025,2063,共6页
Labeled Immunoassays and Clinical Medicine
基金
北京市卫生健康委员会(编号:首发2020-3-7101)。
关键词
临床特征
急诊
AAD
影响因素
益生菌
疗效
Clinical features
Emergency
AAD
Influencing factors
Probiotics
The curative effect
