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病例报告:肠内氧疗成功治疗儿童梭状芽孢杆菌结肠炎。

Case report of successful treatment of clostridial colitis in a child using enteral oxygen therapy.

机构信息

Almazov National Medical Research Centre, Russia.

出版信息

Anaesthesiol Intensive Ther. 2022;54(1):97-98. doi: 10.5114/ait.2022.112887.

Abstract

Clostridioides difficile infection (CDI) has become a serious medical and epidemiological problem with a marked increase in incidence and severity [1]. CDI is responsible for 15-25% of all anti-biotic-associated diarrhea cases, with a considerable increase in the 21st century [2]. Recommended first-line therapy for CDI involves oral vancomycin [1]. Oxygen therapy might be a variant of etiological therapy for anaerobic infection, including CDI [3]. Here we present a case of successful treatment of clostridial colitis in a child by enteral oxygen administration (state scientific project "Investigation of gastrointestinal tract nondigestive functions and the role of enteral oxygenation"). Ethical approval for the clinical usage of enteral oxygen administration was provided by the local ethical committee. Informed consent of the patient's mother was obtained for enteral oxygen therapy. A child was delivered by Caesarean section at 32 weeks of gestation. The mother was infected with herpes simplex virus and cytomegalovirus infections. Moreover, the pregnancy was exacerbated by chronic placental insufficiency, fetal delay syndrome, and moderate intranatal asphyxia. The child's condition was critical from birth because of prematurity and respiratory failure, and he received non-invasive respiratory support (nasal positive airway pressure).

摘要

艰难梭菌感染(CDI)已成为一个严重的医学和流行病学问题,其发病率和严重程度明显增加[1]。CDI 占所有抗生素相关性腹泻病例的 15-25%,在 21 世纪有相当大的增加[2]。CDI 的一线治疗推荐使用口服万古霉素[1]。氧疗可能是包括 CDI 在内的厌氧感染的病因治疗的一种变体[3]。在这里,我们通过肠内氧疗(国家科学项目“胃肠道非消化功能的研究和肠内氧合作用的作用”)成功治疗了一例儿童梭状芽胞杆菌结肠炎。肠内氧疗的临床应用已获得当地伦理委员会的伦理批准。获得了患儿母亲对肠内氧疗的同意。一名儿童在 32 周妊娠时通过剖宫产分娩。母亲感染单纯疱疹病毒和巨细胞病毒感染。此外,妊娠还因慢性胎盘功能不全、胎儿发育迟缓综合征和中度宫内窒息而恶化。由于早产和呼吸衰竭,患儿从出生起病情就很危急,接受了无创性呼吸支持(鼻正压通气)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ec/10156475/364f75795096/AIT-54-46249-g001.jpg

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