尿毒症患者头孢菌素脑病临床分析

A Clinical Study on Uremic Patients with Cephalosporin Encephalopathy

目的:探讨尿毒症患者头孢菌素脑病的发病机制和临床特点。方法:对31例尿毒症头孢菌素脑病患者使用的头孢类药物及发病后治疗进行分析。结果:头孢菌素治疗尿毒症合并感染可引起脑病。第1、2、3代头孢菌素脑病有不同特点。第1代头孢菌素脑病多发生于用药剂量未作适当调整且未规则血透病人,发病后血透效果好。第3代头孢菌素脑病在血透病人也会发生,发生后血透疗效差,但停药后可自行缓解。第2代头孢菌素引起脑病,血透效果差,且不能自行缓解,预后最差。结论:尿毒症患者使用头孢菌素时应注意药物选择及剂量调整,发生脑病后应根据药物药理特点治疗。

Objective: To Study the etiopathology and clinical features of uremic patients with cephalosporin encephalopathy. Methods: The cephalosporins and treatments of 31 uremic patients with cephalosporin encephalopathy were analysed. Results: Cephalosporin can cause encephalopathy in uremic patients. The encephalopathy induced by three generations cephalosporins had different features. The first-generation cephalosporin encephalopathy occurred in patients without adequate drugs dosage adjustment and routine hemodialysis, the treatment of hemodialysis had little effect, but patients can relieve spontaneously. The second-generation cephalosporin drugs cause encephalopathy more frequently, the treatment of hemodialysis had little effect, and patients can not relieve spontaneously, the prognosis was the worst. Conclusions; The attention should be paid to the choice of cephalosporin drugs and dosage adjustment in uremic patients. Cephalosporin encephalopathy should be treated according to the pharmacologic features of the drugs.