Analysis About Clinical Characteristics, Diagnosis And Treatment Of Pseudomembranous Colitis

Objective: Antibiotic associated diarrhea is common in clinical, and severe cases cancause pseudomembranous colitis.The lack of understanding and appropriate treatmentof the disease will cause bad consequence to the patients.In order to improve theunderstanding of the disease,we summarized the risk factors, the clinicalmanifestations,the endoscopic features and the experience of the diagnosis andtreatment of the40patients with pseudomembranous colitis.Methods: The clinical data of the40inpatients with pseudomembranous colitis intwo3armour hospital of fujian were analyzed retrospectively during May2007andApril2014.We used electronic medical records system to record the patients’ medicalhistories,clinical manifestations,laboratory results,endoscopic examinations andtreatments,then applied statistical methods to deal with the data and summarized thecharacteristics.Results:1) The median age of the40patients was73years old, and the patients more than60years old accounted for70%.34cases (85%) were associated withconcomitant diseases. The patients which had suffered abdominal surgeries were13cases,4cases had other operations,4cases had performed appendectomies before.10cases had chronic obstructive pulmonary disease,7cases had suffered malignanttumors after radiotherapy and chemotherapy,5cases had diabetes.2) All of patients had used antibiotics before,and the ratio of community acquiredinfection and hospital acquired infection was4.0:1.16cases only used oneantibiotic, and24cases applied2or more antibiotics.The time from the application ofantibiotics to the appearance of diarrhea was3-60days,the average was11.22±10.0-4days.3) All of the patients were divided into3types, mild in8cases, medium in20cases, severe in12cases.10cases of the patients had the infectionof abdominal cavity.Fecal fungi culture producing candida albicans was18cases.There were9mild,19moderate and12severe by colonoscopyclassification.4)32patients got PPI acid suppression therapy, in which26patients had taken PPIbefore the onset of illness.9cases of the patients with mild to moderate symptomstopped using antibiotics for treatments,12got oral metronidazole and cured. Fivepatients with moderate to severe symptom took oral metronidazole combined withoral vancomycin for treatments.However,the patients getting intravenous vancomycinfor treatment were14cases, including11cases were cured,2cases got healed withteicoplanin,1got fecal bacteria transplantation.Conclusion: Firstly, elderly patients suffering with basic diseases or abdominalsurgical operations were the susceptible persons of pseudomembranous colitis,andthe patients using broad-spectrum antibiotics should be careful ofgetting pseudomembranous colitis especially the people whoused combinedantibiotics.Secondly,we should be cautious to use PPI for prone patients withpseudomembranous colitis.Thirdly,We should pay attention to the patients ofpseudomembranous colitis with intestinal fungal infection,when diagnosing andtreating the diseases clinically.Fourthly,it was effective to use intravenousvancomycin for treatment when oral treatment was invalid for thesevere pseudomembranous colitis patients, especially the persons with abdominalcavity infection.