多黏菌素B致神经肌肉阻滞的案例分析与文献复习  

Case Analysis and Literature Review of Polymyxin B-Induced Neuromuscular Block

作　　者：乌丹 李利欣 郭冬杰[3] WU Dan;LI Li-xin;GUO Dong-jie(Department of Pharmacy,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010010,China;Department of Pharmacy,Ulanqab Central Hospital,Ulanqab Inner Mongolia Autonomous Region 012000,China;Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100031,China)

机构地区：[1]内蒙古自治区人民医院药学处,呼和浩特010010 [2]乌兰察布市中心医院药学处,内蒙古自治区乌兰察布012000 [3]中日友好医院药学部,北京100031

出　　处：《抗感染药学》2024年第10期1000-1004,共5页Anti-infection Pharmacy

摘　　要：目的:综合现实病例和相关文献报道,分析多黏菌素B所致神经肌肉阻滞的临床特点,为临床多黏菌素B的用药安全提供参考。方法:采集临床上1例多黏菌素B致神经肌肉阻滞病例的发生特点,并以“多黏菌素(polymyxin)”、“神经毒性(neurotoxicity)”或“神经肌肉阻滞(neuromuscular block)”为主题词在国内外数据库中检索相关文献,采集其中所报病例的相关资料,分析多黏菌素B所致神经肌肉阻滞的临床特点。结果:共检索到有效文献6篇,涉及病例8例;在9例多黏菌素B致神经肌肉阻滞病例中,有8例发生于首次用药后的5 d内,而其临床表现主要为呼吸困难(7例)和口周异常(5例),其中有6例呼吸困难患者进行了气管插管或气管切开等处置;经过处置,除1例后续因发生感染性休克而死亡外,其余均好转或痊愈。结论:神经肌肉阻滞为多黏菌素B较少见的不良反应,尽管少见,但其结果却较为严重,尤其是呼吸困难应着重关注,对此临床应加强多黏菌素B的用药监护,以保障患者的用药安全。Objective:To analyze the clinical characteristics of polymyxin B-induced neuromuscular block based on actual cases and relevant literature reports,and provide reference for the clinical medication safety of polymyxin B.Methods:The clinical characteristics for occurrence of one patient with polymyxin B-induced neuromuscular block were collected,and the relevant literatures were searched from Chinese and foreign databases using"polymyxin","neurotoxicity"or"neuromuscular block"as keywords.The relevant data of the reported cases were collected,and the clinical characteristics of polymyxin B-induced neuromuscular block were analyzed.Results:A total of 6 valid articles were searched,involving 8 cases.Among 9 cases with polymyxin B-induced neuromuscular block,8 cases occurred within 5 days after the first medication,with the main clinical manifestations of dyspnea(7 cases)and perioral abnormality(5 cases).Six patients with dyspnea underwent endotracheal intubation or tracheotomy.After treatment,one case died of septic shock,and the rest cases improved or were cured.Conclusion:Neuromuscular block is a rare adverse reaction of polymyxin B.Although rare,its consequences are serious,especially special attention should be paid to dyspnea.Therefore,clinical monitoring of the use of polymyxin B should be strengthened to ensure the safe medication for patients.

关 键 词：多黏菌素B 神经肌肉阻滞 呼吸困难 药物不良反应 

分 类 号：R978.16[医药卫生—药品] R961[医药卫生—药学]