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儿童抗生素治疗相关的伪膜性结肠炎:一例报告及文献复习

Pseudomembranous colitis associated with antibiotic therapy in a child: report of a case and review of the literature.

作者信息

Lazar H L, Wesley J R, Weintraub W H, Coran A G

出版信息

J Pediatr Surg. 1978 Oct;13(6):488-91. doi: 10.1016/s0022-3468(78)80311-x.

Abstract

A case of pseudomembranous colitis is presented in a child with multiple medical problems who received intraoperative antibiotics. Despite aggressive medical management and operative intervention, the patient died. All patients who develop diarrhea after receiving antibiotics should be suspected of having pseudomembranous colitis. Sigmoidoscopy and hyaque enema should be performed to confirm the diagnosis and all antibiotics should be discontinued. Aggressive medical management consisting of intravenous fluids, albumin, lactinex granules, fecal enemas, and cholestyramine should be instituted. Surgery should be considered only in the face of perforation, toxic megacolon, peritonitis, and failure of medical management with disease limited to the colon.

摘要

本文报告一例患有多种疾病并在术中接受抗生素治疗的儿童发生假膜性结肠炎的病例。尽管采取了积极的内科治疗和手术干预,患者仍死亡。所有在接受抗生素治疗后出现腹泻的患者都应怀疑患有假膜性结肠炎。应进行乙状结肠镜检查和水灌肠以确诊,并且应停用所有抗生素。应采取积极的内科治疗,包括静脉输液、白蛋白、乳酸菌颗粒、粪便灌肠和消胆胺。仅在出现穿孔、中毒性巨结肠、腹膜炎以及疾病局限于结肠且内科治疗失败的情况下才考虑手术。

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