Results of faecal donor instillation therapy for recurrent Clostridium difficile-associated diarrhoea
Results of faecal donor instillation therapy for recurrent Clostridium difficile-associated diarrhoea
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DOI：
10.3109/00365548.2010.499541
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发表时间：
2010-12-01
影响因子：
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通讯作者：
Sundoy, Anders
中科院分区：
文献类型：
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作者：
Garborg, Kjetil;Waagsbo, Bjorn;Sundoy, Anders
我们在这项回顾性研究中报告了40例复发性艰难梭菌相关性腹泻（CDAD）患者的粪便供体滴注治疗（FDIT）成功率为83%，这些患者于1994年至2008年在挪威一家中型医院接受治疗。粪便移植物通过胃镜注入十二指肠或通过结肠镜注入结肠，由近亲或其他家庭成员作为供体。29例（73%）首次治疗成功，80天内未记录到胰腺疾病复发。在11例对首次滴注治疗无效的患者中，6例患者接受了第二次滴注，其中4例成功。共有33例患者（83%）成功接受FDIT治疗。在7例无应答者中，5例因长期肠道疾病和合并症而病情严重，并在术后80天内死亡，2例被认为患有炎症性肠病，对皮质类固醇治疗有应答。未观察到FDIT的不良反应。根据我们的经验，该手术易于执行，耐受性良好，有效，在选定的病例中可能是一种有价值的治疗选择。
We report a success rate of 83% with faecal donor instillation therapy (FDIT) in this retrospective study of 40 patients with recurrent Clostridium difficile-associated diarrhoea (CDAD), treated at a medium sized Norwegian hospital from 1994 through 2008. The stool transplant was instilled either in the duodenum through a gastroscope or in the colon through a colonoscope with next of kin or other household member as donor. In 29 cases (73%) the first treatment was successful, with no documented recurrence of diarrhoeal disease within 80 days. Of the 11 patients failing to respond to the first instillation treatment, 6 patients received a second instillation, 4 of which were successful. A total of 33 patients (83%) were successfully treated with FDIT. Of the 7 non-responders, 5 were seriously ill due to long lasting diarrhoeal disease and co-morbidity and died within 80 days after the procedure, and 2 were believed to have inflammatory bowel disease with response to corticosteroid treatment. No adverse effects of FDIT were observed. In our experience the procedure is easy to perform, well tolerated, effective, and may be a valuable treatment option in selected cases.