本文選題：神經(jīng)重癥　切入點(diǎn)：抗生素相關(guān)性腹瀉　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析我院神經(jīng)重癥監(jiān)護(hù)室患者抗生素相關(guān)性腹瀉的臨床特點(diǎn)及治療效果,為神經(jīng)重癥監(jiān)護(hù)室患者合理使用抗生素提供依據(jù)。方法:對(duì)青島大學(xué)醫(yī)學(xué)院附屬醫(yī)院神經(jīng)重癥監(jiān)護(hù)室2014年1月~2016年6月收治的無(wú)胃腸道利用等禁忌證神經(jīng)重癥患者260例進(jìn)行回顧性統(tǒng)計(jì)分析。分析使用抗生素對(duì)患者腸道菌群的影響,同時(shí)比較抗生素使用的劑量、使用時(shí)間及聯(lián)合用藥對(duì)腸道菌群失調(diào)的影響,比較不同治療方法對(duì)胃腸道功能恢復(fù)的治療效果。結(jié)果:1.我院神經(jīng)重癥監(jiān)護(hù)室抗生素相關(guān)性腹瀉的發(fā)生率為29.2%。2.發(fā)生抗生素相關(guān)腹瀉的患者總體年齡偏大,APACHE評(píng)分高,住院天數(shù)更長(zhǎng),血清白蛋白數(shù)值低,并且其差異均具有統(tǒng)計(jì)學(xué)意義(p0.05)。3.使用抗生素患者腸道菌群失調(diào)率顯著高于未使用抗生素患者(分別為36.5%、11.5%),差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。4、腸道菌群失調(diào)發(fā)生率與抗生素使用的時(shí)間、劑量及聯(lián)合應(yīng)用的種類呈正相關(guān),差異均具有統(tǒng)計(jì)學(xué)意義(p0.05)。5、對(duì)腸道菌群失調(diào)患者76例分別采用三種不同治療方法,發(fā)現(xiàn)停用抗生素并應(yīng)用益生菌或萬(wàn)古霉素治療組與單獨(dú)停用抗生素組比較,其胃腸道功能改善情況更明顯,且差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:神經(jīng)重癥監(jiān)護(hù)室患者抗生素相關(guān)性腹瀉發(fā)生率較高,且與抗生素使用的劑量、時(shí)間及聯(lián)合種類有關(guān)。及時(shí)診斷、停用抗生素、口服益生菌或萬(wàn)古霉素是治療的重要措施。
[Abstract]:Objective: to analyze the clinical characteristics and therapeutic effect of antibiotic associated diarrhea in patients with neurologic intensive care unit (NICU) in our hospital. Methods: to provide evidence for rational use of antibiotics in patients with neurologic intensive care unit (NICU). Methods: patients with severe neurological diseases without contraindications such as gastrointestinal utilization were treated in Neurointensive Care Unit, affiliated Hospital of Qingdao University Medical College from January 2014 to June 2016. The influence of antibiotics on intestinal flora of patients was analyzed retrospectively. At the same time, the effects of dosage, time and combination of antibiotics on intestinal flora disorder were compared. Results 1. The incidence of antibiotic associated diarrhea in neurointensive care unit was 29.2.2.The patients with antibiotic associated diarrhea had higher Apache score. The length of stay in hospital is longer and the value of serum albumin is low. And the difference was statistically significant (P 0.05). The intestinal flora imbalance rate in patients with antibiotics was significantly higher than that in patients without antibiotics (36.5%). The difference was statistically significant (p 0.05 路4). The incidence of intestinal flora disorders and the time of antibiotic use were significantly higher than those of patients without antibiotics. There was a positive correlation between the dosage and the type of combined use, and the difference was statistically significant (P 0.05). 76 patients with intestinal dysbacteriosis were treated with three different methods. The results showed that the improvement of gastrointestinal function was more obvious in the probiotic or vancomycin group than in the control group. Conclusion: the incidence of antibiotic associated diarrhea in patients in neurointensive care unit is high, and it is related to the dosage, time and combination of antibiotics. Oral probiotics or vancomycin is an important measure of treatment.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R459.7

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