血透患者应用头孢菌素后并发抗生素脑病的临床分析  

Clinical analysis of patients with antibiotic encephalopathy induced by cephalosporins

作　　者：任强[1] REN Qiang(Dujiangyan Municipal People’s Hospital, Sichuan 611830, China)

机构地区：[1]都江堰市人民医院

出　　处：《中国处方药》2019年第7期53-54,共2页Journal of China Prescription Drug

摘　　要：目的探讨血透患者应用头孢菌素后并发抗生素脑病的相关性。方法回顾性分析2012~2015年43例应用头孢菌素并发抗生素脑病的血透患者资料,停用头孢菌素2~5d后未好转,行血液透析治疗。比较行血透前后患者尿素氮、血肌酐、血清磷、血清钙、β2微球蛋白水平及头孢菌素的使用时间和累计量。结果43例血透患者中应用头孢呋辛10例,头孢他啶15例,头孢哌酮钠他唑巴坦13例,头孢曲松5例,均在用药2~9d后出现中枢精神症状,经停用头孢菌素及血液透析联合血液灌注治疗后症状缓解、消失。结论血透患者应用头孢菌素时应警惕抗生素脑病的发生,调整剂量或用法、及时停药和血液透析联合血液灌注治疗可有效缓解抗生素脑病的发生。Objective Analyze mechanism,causes and treatment of antibiotics encephalopathy induced by cephalosporins which was used for patients with chronic renal failure and hemodialysis. Methods Retrospectively analyze clinical data of 43 antibiotic encephalopathy patients induced by cephalosporins from 2011 to 2014 in our hospital. Results In 43 patients, 10 cases used cefuroxime, 15 cases used ceftazidime, 13 cases used cefoperazone sodium and tazobactam, and 5 cases used ceftriaxone. After 2 to 9 days ,all patients appeared central mental symptoms .after discontinuation of cephalosporin drugs and using hemodialysis combined with hemoperfusion treatment ,these symptoms alleviated or disappeared. Conclusion Hemodialysis patients should be alert to antibiotic encephalopathy when using cephalosporin drugs.If it happened,doctor should adjust dose ,stop using drugs and hemodialysis combined hemoperfusion treatment ,then effectively alleviate the antibiotic encephalopathy.

关 键 词：头孢菌素 血透 抗生素脑病 

分 类 号：R692.5[医药卫生—泌尿科学] R747.9[医药卫生—外科学]