维持性血液透析患者应用第三代头孢菌素致药物性脑病17例临床分析  

Clinical analysis of encephalopathy induced by cephalosporins in 17 maintenance hemodialysis patients

作　　者：刘林[1] 邓剑波[1] 吴桂明[1] 

机构地区：[1]四川省达州市中心医院肾内科,四川达州635000

出　　处：《中国当代医药》2011年第25期47-48,共2页China Modern Medicine

摘　　要：目的:探讨维持性血液透析患者头孢菌素脑病的发病机制及临床表现。方法:回顾性分析本院17例维持性血液透析患者使用第三代头孢菌素后出现药物性脑病的临床资料。结果:应用第三代头孢菌素后出现神经精神症状主要表现为意识恍惚、头昏、嗜睡、反应迟钝、兴奋多语、思维混乱、语无伦次、意识淡漠、双上肢及头部不自主震颤,有2例四肢抽搐、癫痫大发作。出现神经精神症状后即停用头孢菌素类药物,加做急诊透析或按原方案透析治疗。所有患者神经精神症状在停药后72h内均消失。结论:维持性血液透析患者应用第三代头孢菌素时可出现脑病表现,及时停药、换药、积极血液透析可改善症状。Objective：To discuss the pathogenesis and clinical manifestations of encephalopathy induced by cephalosporins in patients on hemodialysis.Methods：The clinical characteristics of 17 patients on hemodialysis were analyzed retrospectively,who developed encephalopathic syndrome when they were treated with cephalosporins.Results：The encephalopathic syndrome induced by cephalosporins included mental confusion,dizziness,sleepiness,slow responsiveness,thinking disorder,hyperexcitabmty,incoherent,conscious indifference,even seizure in 2 patients.After withdrawal of cephalosporins immediately and with hemodialysis,all the manifestations of neurotoxixity completely recovered in 72 hours.Conclusion：Cephalosporins used in patients with renal failure on hemodialysis might due to encephalopathy,which can be treated by withdrawal of the drugs and hemodialysis.

关 键 词：肾功能不全 慢性 血液透析 脑病 头孢菌素 

分 类 号：R743[医药卫生—神经病学与精神病学]