β-内酰胺类抗生素致尿毒症患者神经系统不良反应

Nervous adverse reactions induced by β-lactam antibiotics in patients with uremia

目的探讨β-内酰胺类抗生素致尿毒症患者神经系统不良反应的临床特点,提高防治水平。方法分析36例尿毒症患者使用的β-内酰胺类抗生素的品种、剂量,探讨其神经系统不良反应的临床特点、治疗及转归。结果 36例尿毒症患者停用β-内酰胺类抗生素、加强血液净化治疗后,神经系统不良反应多于3～5 d消失,无任何神经系统后遗症。结论β-内酰胺类抗生素致尿毒症患者神经系统不良反应的发生率与抗生素剂量呈正相关,不良反应以肢体震颤、兴奋、失眠、谵妄最常见;对于神经系统不良反应,若能及早发现、及时停药、合理治疗,绝大多数患者预后良好。

Objective To investigate the β-lactam antibiotic-induced nervous adverse reactions in patients with uremia, and improve its prevention and treatment. Methods The species and dosage of β-lactarn antibiotics were analyzed, and the clinical features ,treatment and outcome of adverse effects in nervous system were discussed. Results The adverse reactions of nervous system disappeared in 3 - 5 d after stopping β-lactam antibiotics, strengthening blood purification therapy without any neurological sequelae. Conclusion The adverse rate of nervous system is positively correlated with the dosage of antibiotics. The most common adverse reactions are body tremors, excitement, insomnia, delirium. The majority of patients with nervous adverse reaction has good prognosis after early detection, timely with- drawal and reasonable treatment.