老年糖尿病性便秘合并重型伪膜性肠炎1例

郑翔; 李琰华

doi:10.16766/j.cnki.issn.1674-4152.002752

老年糖尿病性便秘合并重型伪膜性肠炎1例

doi: 10.16766/j.cnki.issn.1674-4152.002752

郑翔,
李琰华^,

浙江中医药大学附属第二医院全科医学科，浙江杭州 310000

详细信息

通讯作者:
李琰华, E-mail: liyanhua330@163.com

中图分类号: R587.2 R574
计量
- 文章访问数: 118
- HTML全文浏览量: 44
- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2022-06-12
- 网络出版日期: 2022-12-30

摘要

- 糖尿病性便秘 /
- 伪膜性肠炎 /
- 哌拉西林他唑巴坦钠

HTML全文

图 1 肠镜下结肠黏膜可见密集白苔

注：A为直肠；B为乙状结肠。

Figure 1. Dense white fur can be seen in colon mucosa under colonoscopy

下载: 全尺寸图片幻灯片

图 2 治疗前后患者每日排便量

Figure 2. Daily stool volume of patients before and after treatment

下载: 全尺寸图片幻灯片

图 3 治疗前后患者腹围变化

Figure 3. Abdominal circumference of patients before and after treatment

下载: 全尺寸图片幻灯片

表 1 患者肾功能变化情况

Table 1. Changes in renal function

日期	血钾(mmol/L)	肌酐(μmol/L)	尿素氮(mmol/L)	24小时尿量(mL)
11月29日	3.34	178.7	13.54	1 200
12月5日	3.77	157.9	7.04	1 200
12月14日	3.20	131.2	5.19	1 800
12月18日	3.79	108.3	5.45	2 900
1月1日	4.75	92.9	5.14	2 600

下载: 导出CSV

参考文献(17)

[1]	MA Q T, LI Y Q, LI P F, et al. Research progress in the relationship between type 2 diabetes mellitus and intestinal flora[J]. Biomed Pharmacother, 2019, 117: 109138. DOI: 10.1016/j.biopha.2019.109138.
[2]	LU H L, ZHANG C M, SONG N N, et al. Colonic PDGFRα overexpression accompanied forkhead transcription factor FOXO3 up-regulation in STZ-induced diabetic mice[J]. Cell Physiol Biochem, 2017, 43(1): 158-171. doi: 10.1159/000480335
[3]	邱涛, 熊瑛, 吴红梅. 老年2型糖尿病患者发生便秘的因素及抬臀干预的影响[J]. 中国老年学杂志, 2020, 40(23): 4940-4944. doi: 10.3969/j.issn.1005-9202.2020.23.005 QIU T, XIONG Y, WU H M. Factors of constipation in elderly patients with type 2 diabetes mellitus and the influence of hip lifting intervention[J]. Chinese Journal of Gerontology, 2020, 40(23): 4940-4944. doi: 10.3969/j.issn.1005-9202.2020.23.005
[4]	FUJISHIRO M, KUSHIYAMA A, YAMAZAKI H, et al. Gastrointestinal symptom prevalence depends on disease duration and gastrointestinal region in type 2 diabetes mellitus[J]. World J Gastroenterol, 2017, 23(36): 6694-6704. doi: 10.3748/wjg.v23.i36.6694
[5]	徐英春, 张曼. 中国成人艰难梭菌感染诊断和治疗专家共识[J]. 协和医学杂志, 2017, 8(2): 131-138. https://www.cnki.com.cn/Article/CJFDTOTAL-XHYX2017Z1011.htm XU Y C, ZHANG M. Expert consensus on diagnosis and treatment of adult Clostridium difficile infection in China[J]. Medical Journal of Peking Union Medical College Hospital, 2017, 8(2): 131-138. https://www.cnki.com.cn/Article/CJFDTOTAL-XHYX2017Z1011.htm
[6]	张玲, 马丽, 陈晓庆, 等. 抗结核药物导致伪膜性肠炎一例并文献复习[J]. 中华老年医学杂志, 2021, 40(2): 193-196. doi: 10.3760/cma.j.issn.0254-9026.2021.02.012 ZHANG L, MA L, CHEN X Q, et al. Pseudomembranous enteritis caused by antituberculotic drugs: A case report and literature review[J]. Chinese Journal of Gerontology, 2021, 40(2): 193-196. doi: 10.3760/cma.j.issn.0254-9026.2021.02.012
[7]	杨静. 1例真菌感染患者抗菌药物致伪膜性肠炎的临床治疗与药学监护[J]. 抗感染药学, 2021, 18(3): 422-425. doi: 10.13493/j.issn.1672-7878.2021.03-033 YANG J. Clinical Treatment and pharmaceutical monitoring of pseudomembranous enteritis caused by antibiotics in a patient with fungal infection[J]. Anti-Infection Pharmacy, 2021, 18(3): 422-425. doi: 10.13493/j.issn.1672-7878.2021.03-033
[8]	ZHOU Y, MAO L Y, YU J, et al. Epidemiology of clostridium difficile infection in hospitalized adults and the first isolation of C. difficile PCR ribotype 027 in central China[J]. BMC Infect Dis, 2019, 19(1): 232. doi: 10.1186/s12879-019-3841-6
[9]	刘俊枫, 李刚, 王文, 等. 艰难梭菌导致的重度伪膜性肠炎1例[J]. 宁夏医科大学学报, 2021, 43(1): 106-108. doi: 10.3969/j.issn.1674-6309.2021.01.023 LIU J F, LI G, WANG W. A case of severe pseudomembranous enteritis caused by Clostridium difficile[J]. Journal of Ningxia Medical University, 2021, 43(1): 106-108. doi: 10.3969/j.issn.1674-6309.2021.01.023
[10]	张俊美, 孙滨滨, 张秀. 肠道微生态重建与粪菌移植[J]. 现代医药卫生, 2017, 33(10): 1472-1474. doi: 10.3969/j.issn.1009-5519.2017.10.011 ZHANG J M, SUN B B, ZHANG X. Intestinal microecology reconstruction and fecal bacteria transplantation[J]. Journal of Modern Medicine & Health, 2017, 33(10): 1472-1474. doi: 10.3969/j.issn.1009-5519.2017.10.011
[11]	CAMMAROTA G, IANIRO G, TILG H, et al. European consensus conference on faecal microbiota transplantation in clinical practice[J]. Gut, 2017, 66(4): 569-580. doi: 10.1136/gutjnl-2016-313017
[12]	张俊美, 王帅, 张欣宇, 等. 粪菌移植治疗复发性重度假膜性肠炎1例并文献回顾[J]. 中国感染控制杂志, 2018, 17(8): 739-741. doi: 10.3969/j.issn.1671-9638.2018.08.018 ZHANG J M, WANG S, ZHANG X Y, et al. Fecal bacteria transplantation for recurrent severe pseudomembranous enteritis: A case report and literature review[J]. Chinese Journal of Infection Control, 2018, 17(8): 739-741. doi: 10.3969/j.issn.1671-9638.2018.08.018
[13]	文良志, 刘凯军, 魏艳玲, 等. 老年人抗生素相关性腹泻的风险及处理[J]. 现代医药卫生, 2018, 34(3): 332-335. doi: 10.3969/j.issn.1009-5519.2018.03.005 LIU L Z, LIU K J, WEI Y L, et al. Risk and management of antibiotic associated diarrhea in the elderly[J]. Journal of Modern Medicine & Health, 2018, 34(3): 332-335. doi: 10.3969/j.issn.1009-5519.2018.03.005
[14]	赵一青, 王慕, 董丽娜, 等. 代谢组学在炎症性肠病诊疗中的研究进展[J]. 中国医药, 2018, 13(11): 1752-1754. doi: 10.3760/j.issn.1673-4777.2018.11.038 ZHAO Y Q, WANG M, DONG L N, et al. Research progress of metabonomics in the diagnosis and treatment of inflammatory bowel disease[J]. China Medicine, 2018, 13(11): 1752-1754. doi: 10.3760/j.issn.1673-4777.2018.11.038
[15]	RUITER-LIGETI J, VICENT S, CZUZOJ-SHULMAN N, et al. Risk factors, incidence, and morbidity associated with obstetric clostridium difficile infection[J]. Obstet Gynecol, 2018, 131(2): 387-391. doi: 10.1097/AOG.0000000000002422
[16]	RILEY T V, KIMURA T. The epidemiology of clostridium difficile infection in Japan: A systematic review[J]. Infect Dis Ther, 2018, 7(1): 39-70. doi: 10.1007/s40121-018-0186-1
[17]	李雪琴, 张蓓茹, 何平, 等. 2型糖尿病合并不同类型肾损伤患者的临床和病理特点比较[J]. 中国医药, 2018, 13(12): 1848-1852. doi: 10.3760/j.issn.1673-4777.2018.12.021 LI X Q, ZHANG B R, HE P, et al. Comparison of clinical and pathological features in patients with type 2 diabetes mellitus complicated with different types of renal injury[J]. China Medicine, 2018, 13(12): 1848-1852. doi: 10.3760/j.issn.1673-4777.2018.12.021