偽膜性腸炎之病例報告

Pseudomembranous Colitis: A Report of Four Cases

徐榮源(Rong-Yaun Shyu) ； 曹為霖(Wei-Lin Tsao) ； 黃卓明(Jwo-Ming Huang) ； 陳全福(Chang-Fu Chen) ； 薛如璋(Lu-Chung Shieu) ； 吳國良(Kuo-Liang Wu)

《Journal of Medical Sciences》 8卷1期 (1987/07) Pp. 53-58

摘要

4例患者經使用抗生素後，產生腹瀉、腹痛及發燒等症狀。經內視鏡檢及組織切片檢查，確定診斷為偽膜性腸炎。其中2例取其病灶組織檢體培養出梭狀芽胞桿菌Clostridium difficile。口服vancomycin治療3至10天後，症狀消失。3例於治療程後再接受乙狀結腸或全結腸鏡複檢，顯示腸粘膜正常或顯著改善。其中1例於停藥5天後復發，再次經vancomycin治療後痊癒。本文謹將此病提出報告，並回顧過去文獻，對此病之病因，致病機轉，流行病學研究，臨床表徵，診斷，治療與預後做詳細討論。

關鍵字

偽膜性腸炎 ； 梭狀芽胞桿菌 ； 梭狀芽胞毒素

並列摘要

Four patients with recent antibiotic exposure suffered from diarrhea, abdominal pain and fever. Pseudomenbranous colitis was diagnosed by endoscopy and/or tissue biopsy. Culture of tissue specimens in 2 of 4 patients grew Clostridium difficile. All patients were treated with oral vancomycin 2 g daily. The symptoms relieved in 3-7 days. Follow-up endoscopic examination in 3 patients showed normal or resolution of lesions. One patient suffered from same symptoms after one course of therapy and relapse of pseudomenbranous colitis was proved by colonoscopy with biopsy. The patient was cured with vancomycin retreatment. Literature was reviewed and etiology, epidemiology, clinical feature, diagnosis, treatment, prognosis and prevention of pseudomenbranous colitis were discussed.

並列關鍵字

Pseudomenbranous colitis ； Clostridium difficile ； Clostridium difficile toxin