脓毒症患者并发抗生素相关性腹泻的危险因素分析OA
Analysis of risk factors for antibiot-associated diarrhea in sepsis patients
目的 探讨脓毒症患者抗生素相关性腹泻(antibiot-associated diarrhea,AAD)的发生情况及危险因素.方法 选取2021 年 7 月至 2023 年 7 月浙江大学医学院附属金华医院重症医学科收治的 126 例脓毒症患者为研究对象,根据是否发生AAD分为AAD组和非AAD组.对比两组患者的临床资料和抗生素使用情况,采用Logistic回归分析探讨影响脓毒症患者并发AAD的危险因素.结果 126 例脓毒症患者呼吸系统感染 72 例,泌尿系统感染 18 例,血流感染 15 例,胸腹腔感染 12 例,其他感染 9 例;32 例(25.4%)并发AAD.Logistic多因素回归分析显示年龄≥60 岁、血乳酸(lactic acid,Lac)及白蛋白(albumin,ALB)水平、应用碳青霉烯类及酶抑制剂类抗生素、抗生素联用、使用激素、住院时间是影响脓毒症患者并发AAD的危险因素(95%CI分别为 0.847～0.983、0.074～0.527、1.147～2.034、0.624～1.687、2.132～5.220、0.439～0.882、0.411～0.853、0.478～0.848,P<0.05).结论 重症医学科脓毒症患者并发AAD的风险较高.年龄≥60 岁、Lac水平、ALB水平、应用碳青霉烯类及酶抑制剂类抗生素、抗生素联用、使用激素、住院时间是影响脓毒症患者并发AAD的危险因素.
Objective To explore the incidence and risk factors of antibiot-associated diarrhea(AAD)in patients with sepsis.Methods A total of 126 patients with sepsis admitted to Department of Critical Care Medicine,Jinhua Hospital Affiliated to Zhejiang University School of Medicine from July 2021 to July 2023 were selected as the subjects.They were divided into AAD group and non AAD group based on whether AAD occurred.Compare the clinical data and antibiotic use between two groups of patients,and use Logistic regression analysis to identify the risk factors for AAD in sepsis patients.Results There were 72 cases of respiratory system infections,18 cases of urinary system infections,15 cases of bloodstream infections,12 cases of chest and abdominal infections,and 9 cases of other infections in 126 patients with sepsis;32 cases(25.4%)developed AAD.Logistic multiple regression analysis showed that age≥60 years,lactic acid(Lac)level,albumin(ALB)level,use of carbapenems and enzyme inhibitors,combination of antibiotics,using hormones,and length of hospital stay were risk factors for AAD in sepsis patients(95%CI were 0.847-0.983,0.074-0.527,1.147-2.034,0.624-1.687,2.132-5.220,0.439-0.882,0.411-0.853,0.478-0.848,P<0.05).Conclusion Sepsis patients of department of critical care medicine have a high risk of developing AAD.Age≥60 years old,Lac level,ALB level,use of carbapenems and enzyme inhibitors,combination of antibiotics therapy,using hormones,and length of hospital stay are risk factors for AAD in sepsis patients.
郑卫涛;王生超;邵兴;童洪杰;陈琨
浙江大学医学院附属金华医院重症医学科,浙江金华 321000
临床医学
脓毒症重症医学科抗生素相关性腹泻危险因素
SepsisDepartment of critical care medicineAntibiot-associated diarrheaRisk factors
《中国现代医生》 2024 (018)
8-12 / 5
浙江省金华市中医药科学技术研究计划项目(2023KY01)
评论