头孢曲松钠静脉滴注致低血钙搐搦

Hypocalcemic tetany caused by intravenous infusion of ceftriaxone sodium

1例38岁女性,因胆囊结石,慢性胆囊炎急性发作入院。给予头孢曲松钠2.0g溶入0.9%氯化钠注射液250ml中静脉滴注治疗。静脉滴注药液约150ml后,患者出现手足搐搦、烦躁等症状,其血钙为1.85mmol/L,血钠、血钾,肝肾功能及血糖均正常。立即停药,给予抗过敏及对症治疗不见好转。给予10%葡萄糖酸钙注射液10ml加入25%葡萄糖注射液20ml中静脉注射,45min后上述症状逐渐缓解,8h后血钙升至2.35mmol/L。第2天头孢曲松钠改为氨苄青霉素,上述症状未再出现。

A 38-year-old woman was hospitalized with cholecystolithiasis and acute episode of chronic cholecystitis. The woman was given an Ⅳ infusion of ceftriaxone sodium 2.0 g dissolved in 250ml of sodium chloride injection 0.9%. After about 150ml of the infusion, she experienced tetany and dysphoria. Her blood calcium level was 1.85 mmol/L; her blood sodium level, blood potassium level, liver and renal function, and blood glucose level were within normal limits. Ceftriaxone sodium was withdrawn immediately. Antianaphylactic and symptomatic treatment showed no improvement in her symptoms. The patient was administered with 10 ml of calcium gluconate 10% diluted in 20ml of glucose 25% by intravenous injection. Forty-five minutes later, the above-mentioned symptoms resolved gradually; eight hours later, her blood calcium level incrcased to 2.35 mmol/L. The next day, ceftriaxone was replaced with ampicillin and the described above symptoms did not reappear.