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目的:探讨慢性阻塞性肺疾病患者抗生素相关性腹泻(AAD)的发病率、潜伏期、临床特点及防治措施。方法:对我院呼吸内科慢性阻塞性肺疾病968例应用抗生素的住院患者,自抗生素应用之日起进行为期30d的前瞻性追踪观察。结果:AAD发病率为8.47%(82/968),潜伏期为(8.35±5.19)d;AAD患者以单纯性腹泻最多,占84.15%(69/82);较易引起AAD的抗生素为头孢菌素(42.68%)、青霉素类(23.17%);抗生素使用时间≥7d,联合使用抗生素3种及以上,AAD发病率明显增高;82例AAD患者经停用或换用抗生素,服用微生态制剂、甲硝唑或万古霉素等处理,痊愈71例(86.59%),好转10例(12.20%),无效1例(1.21%)。结论:AAD是一种常见的抗生素治疗的并发症,合理使用抗生素是预防发生AAD的有效措施。
Objective: To investigate the incidence, latency, clinical features and prevention and treatment of antibiotic-associated diarrhea (AAD) in patients with chronic obstructive pulmonary disease. Methods: A total of 968 hospitalized patients with chronic obstructive pulmonary disease (COPD) using antibiotics in our hospital were prospectively followed up for 30 days from the date of antibiotic application. Results: The incidence of AAD was 8.47% (82/968) and the incubation period was (8.35 ± 5.19) days. AAD patients had the most simple diarrhea, accounting for 84.15% (69/82). AAD was more likely to be cephalosporin (42.68%) and penicillins (23.17%). The antibiotic use time was more than 7 days. The incidence of AAD was significantly increased when three or more antibiotics were used in combination. The antibiotics in 82 AAD patients were discontinued or replaced with probiotics. 71 cases (86.59%) were cured, 10 cases (12.20%) were improved, and 1 case (1.21%) was ineffective. Conclusion: AAD is a common complication of antibiotic therapy. The rational use of antibiotics is an effective measure to prevent AAD.