恶性综合征并发急性肾功能衰竭诊治体会

The ekperience of treat Neurot eptic malignant syndrome combined acute renal failure

目的为了解国人抗精神病药物致合恶性综征并发急性肾功能衰竭临床表现的特点,促进临床合理用药。方法通过对本院2例恶性综合征并发急性肾功能衰竭及外院会诊1例恶性综合征并发急性肾功能衰竭临床资料及国内有关临床资料进行总结分析。结果以肌强直、发热、意识障碍及植物神经功能紊乱等为主,结合国内外文献资料。结论引起恶性综合征,可由高效价精神药物,多种药物联合使用或新型抗精神病药物等引起。作者认为可能与患者抗精神病药物慢代谢型、超慢代谢超型及不代谢型三种形式有关,在治疗中,抗精神病药物最好是单一用药,小剂量开始,逐渐加量,观察疗效等,如发生,停用抗精神病药物,给予血透等处理,是治疗恶性综合征并发急性肾功能衰竭最重要措施。

[Objective] To understand clinical characteristics of Neurot eptic malignant syndrome combined acute renal failure caused by antipsychotics,promote clinical rational drug using.[Methods] Summarize and analyze clinical data through two cases of Neurot eptic malignant syndrome combined acute renal failure in our hospital and one case outside the hospital,reference national clinical data.[Results] As myotonia,fever,disturbance of consciousness and autonomic dysfunction for the main performance,combined with domestic and foreign literature.[Conclusions] Neurot eptic malignant syndrome may be caused by high titer of antipsychotics,multi-drug combination or new antipsychotics,etc..Authors believe may be related to three forms of slow metabolism of antipsychotics in patients,super-ultra-slow metabolic type and not metabotropic.In therapy,antipsychotics preferably use singly,begin with a small dose,and gradually increase.In the event,disable antipsychotics,and hemodialysis treatment is the most important measures of Neurot eptic malignant syndrome combined acute renal failure.