大剂量头孢拉定致小儿血尿系列病例分析

Case Analysis of Children's Hematuria Caused with Large Dose of Cefradine

目的 :观察静滴头孢拉定致小儿血尿的临床过程 ,并探讨其病因。方法 :分析 12例患儿的临床表现和相关的实验室检查数据。结果 :①静滴头孢拉定后 1d内出现血尿者 10例 ,占 83.33% ;②停用头孢拉定后血尿持续 2d者 5例 ,占 4 1.6 7% ,持续 3d者 7例 ,占 5 8.33% ;③观察 6例患儿的尿液红细胞形态 :1例为肾小球性血尿 ,5例为非肾小球性血尿 ;④ 2 / 3患儿出现蛋白尿 ,1/ 2患儿尿白细胞阳性 ,所有患儿的尿蛋白及尿白细胞均随血尿的消失而转阴 ;⑤排血尿前出现腹痛 5例 ,占 4 1.6 7% ,均为 3岁以上患儿。结论 :血尿发生的原因可能与药物剂量偏大、静脉注射速度较快、个体差异、药物引起出血倾向以及婴幼儿对药物的耐受力相对较差有关。患儿除停用头孢拉定外 ,无需特殊处理 。

Objective: To observe a clinical process of children's hematuria caused with large dose of cefradine by intravenous infusion and explore the cause.Methods: The clinical expressions and the relativedata of laboratory in 12 cases of ill children were analysed. Result: 1) The hematuria occured one day after cefradine given by intravenous infusion(83.33%); 2) the hematuria continued 2 days in 5 cases after cefradine disconginued(41.67%), continued 3 days in 7 cases(58.33%); 3) one caes was glomerular hematuria, 5 cases were non glomerular in 6 cases of red cell's shape observed; 4) 2/3 cases occured proteinuria, 1/2 cases were found positive white cells; 5) abdominal pain occured in >3 years old of 5 cases before hematuria occured(41.67%). Conclusion: The causes causing hematuria may be as following: 1) Overdose of drug; 2) too quick intravenous infusion; 3) individual difference; 4) tolerance of infant and younger childrer are lower relatively.