摘要
目的:评估抗生素在中度缺血性结肠炎(IC)患者治疗中的价值。方法:纳入明确诊断为中度IC的患者102例,根据有无使用抗生素分为抗生素组(71例)和对照组(31例)。收集两组基线资料、实验室检查结果、影像学检查结果、内镜检查结果及临床结局,并进行组间比较。结果:两组患者人口学特征、临床症状、合并症、腹部手术史比较差异无统计学意义(均P>0.05)。抗生素组白细胞计数高于对照组,黏膜白苔占比低于对照组(均P<0.05)。两组C-反应蛋白(CRP)、白蛋白、D-二聚体水平及粪便隐血阳性占比比较差异无统计学意义(均P>0.05)。抗生素组住院时间、腹痛缓解时间、便血消失时间长于对照组,住院费用高于对照组(均P<0.05)。所有患者均治愈出院,30 d病死率、30 d结肠切除手术率均为0。结论:对于无全身感染证据的中度IC患者,常规预防性抗生素治疗不但缺乏获益依据,而且可能增加医疗负担。
Objective:To evaluate the value of antibiotics in the treatment of patients with moderate ischemic colitis(IC).Methods:A total of 102 patients with moderate IC were included and divided into the antibiotic group(71 cases)and the control group(31 cases)based on whether they had used antibiotics.Baseline data,laboratory test results,imaging examination results,endoscopic examination results,and clinical outcomes were collected and compared between two groups.Results:There were no statistically significant differences in demographic characteristics,clinical symptoms,comorbidities,history of abdominal surgery between two groups(all P>0.05).The white blood cell count in the antibiotic group was higher than that in the control group,and the proportion of mucosal white plaque was lower than that in the control group(all P<0.05).There were no statistically significant differences in C-reactive protein(CRP),albumin,D-dimer levels,and the proportion of positive fecal occult blood between two groups(all P>0.05).The antibiotic group exhibited prolonged hospitalization,delayed symptom resolution(abdominal pain and hematochezia),and higher direct medical costs(all P<0.05).All patients achieved clinical recovery without mortality or colectomy within 30 days.Conclusion:For moderate IC patients without evidence of systemic infection,routine prophylactic antibiotic treatment not only lacks a basis for benefit but may also increase the medical burden.
作者
任喜梅
张永甜
徐桂芳
汪胜林
REN Ximei;ZHANG Yongtian;XU Guifang;WANG Shenglin(Department of Gastroenterology,the Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,China;Department of Gastroenterology,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing 210008,China)
出处
《陕西医学杂志》
2025年第9期1219-1223,共5页
Shaanxi Medical Journal
基金
江苏省重点研发计划(社会发展)专项资金资助项目(BE2021601)。
关键词
缺血性结肠炎
抗生素治疗
中度
临床结局
再评估
医疗负担
Ischemic colitis
Antibiotic therapy
Moderate
Clinical outcome
Reevaluation
Medical burden
