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目的探讨伪膜性肠炎(PMC)在危重症患者中的临床表现、诊断及治疗。方法对我院ICU近2年来收治的14例PMC患者的住院资料进行回顾性分析。结果全部患者均在使用广谱抗生素过程中出现腹泻并不同程度伴有其他症状。肠镜检查有典型表现,经停用原抗生素,口服甲硝唑、万古霉素及生态制剂培菲康,支持对症处理后13例治愈。1例死于深部真菌感染。结论在危重症患者治疗过程中,应注意肠功能保护,警惕PMC的发生。一旦出现腹泻应尽早做内镜检查、粪厌氧菌培养,早期诊断,早期治疗。
Objective To investigate the clinical manifestations, diagnosis and treatment of pseudomembranous enteritis (PMC) in critically ill patients. Methods A retrospective analysis was made on the hospitalization data of 14 PMC patients admitted to ICU in our hospital in recent 2 years. Results All patients developed diarrhea during the course of using broad-spectrum antibiotics and were associated with varying degrees of other symptoms. Colonoscopy typical performance, the withdrawal of the original antibiotics, oral metronidazole, vancomycin and ecological agents Peifukang, support symptomatic treatment after 13 cases of cure. One patient died of a deep fungal infection. Conclusion During the treatment of critically ill patients, we should pay attention to the protection of intestinal function and guard against the occurrence of PMC. Endoscopy should be done as soon as possible in case of diarrhea, anaerobic bacteria culture, early diagnosis, early treatment.