头孢曲松相关急性肾后性肾功能不全的临床特点和治疗  

Clinical characteristics and treatment of ceftriaxone-associated postrenal acute renal insufficiency

作　　者：陈真[1] 刘征[1] 时鸿娟 李聪[1] 詹鹰[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030 [2]孝感市第一人民医院肾内科

出　　处：《中华泌尿外科杂志》2012年第8期570-572,共3页Chinese Journal of Urology

摘　　要：目的探讨头孢曲松钠治疗后发生急性肾后性肾功能不全的临床特点和治疗。方法回顾性分析25例使用头孢曲松钠后出现急性肾后性肾功能不全患者的临床资料。男16例，女9例。平均年龄28岁。SCr334．9-1280．5μmol／L，平均635．5txmol／L，BUN8．0-33．9mmol／L，平均18．6mmol／L。14例经膀胱镜放置输尿管支架治疗，11例行保守治疗（碱化尿液、解痉等），比较两组的治疗效果。结果在出现无尿至人院时间，输尿管支架组（1．4±0．7d）显著短于保守治疗组（3．0±1．4d）（P=0．045），余年龄、SCr、BUN水平差异均无统计学意义（P〉0．05）。25例均恢复排尿，2-6d后复查肾功能恢复正常。两组肾功能恢复时间及住院时间比较差异均无统计学意义（P=0．963，P=0．568）。结论头孢曲松钠治疗后发生急性肾功能小全须引起高度蘑视，只要及早治疗，通过保守治疗或输尿管插管治疗都能取得良好的治疗效果。Objective To investigate the clinical characteristics and treatment of acute postrenal acute renal dysfunction associated with ceftriaxone. Methods Twenty-five cases of the eeftriaxione-associated acute postrenal renal insufficiency were reviewed. There were 16 males and 9 females, mean age 28 years. The serum contents of BUN and Cr were （18.6 ± 7.0） mmol/L and （635.5 ± 248.7） μmol/L, respectively. All patients were divided into two groups depending on the therapy： 1 l patients accepted the drug therapy （alkalinization of the urine, antispasmodic, etc） and 14 patients accepted the intraureteral cannula. The clinical characteristics and the treatment effect were compared between the 2 groups. Results The patients of the intraureteral cannula group （ 1.4 ± 0.7 d） went to hospital earlier than the drug therapy group （3.0 ± 1.4 d） （ P = 0. 045 ） after the symptom of oliguria or anuria appeared. There were no significant differences in serum creatinine, urea nitrogen, and the age between the 2 groups （P 〉 0.05）. All the pa- tients were cured after treatment. There were no significant differences in recovery time （2.9± 1. 1 d and 3.2± 1.2 d, P =0.963） and hospitalization time （7.0±2.3 d and 5.9±3.9 d, P =0.568） between the 2 groups. Conclusions The acute renal failure associated with ceftriaxone should have high attention. The prompt medical attention, including the intraureteral cannula and the drug therapy, can both achieve the satisfvinz curative effect.

关 键 词：头孢曲松 肾功能不伞 急性 治疗结果 

分 类 号：R692.5[医药卫生—泌尿科学]