头孢吡肟致尿毒症患者精神障碍1例及护理

头孢吡肟为第4代头孢菌素,其抗菌谱广,不良反应小,广泛应用于各种感染性疾病的治疗。我科应用头孢头孢吡肟为第4代头孢菌素,其抗菌谱广,不良反应小,广泛应用于各种感染性疾病治疗。我科应用头孢吡肟治疗老年尿毒症肺炎患者出现严重精神症状1例,经积极治疗和护理治愈。介绍如下。患者,女性,56岁,主因咳嗽、咳痰7天,精神障碍2天于2009年1月7日入院。患者既往有慢性肾功能衰竭病史7年,每周3次血液透析治疗。曾反复肺感染治疗好转。     

头孢吡肟临床应用研究进展

头孢吡肟 (ｃｅｆｅｐｉｍｅ)是第四代注射用头孢菌素 ,其分子结构是在三代头孢菌素基础上 ,于 7 氨基头孢烯类 (7 ＡＣＡ)母核Ｃ 3位引入Ｃ 3’季氨取代基 ,与三代头孢菌素比较它具有以下特点 :(1)更广的抗菌谱即对革兰氏阳性菌有更强的活性 ;(2 )对细菌产生的 β内酰胺酶有更高的稳定性和更低的诱导性 ,尤其是对能分解三代头孢菌素产生高致死率的ＡｍｐＣ酶及部分产超广谱β内酰胺酶 (ＥＳＢＬｓ)有确切的作用 ;(3)能更快地穿透革兰阴性杆菌的外膜且与多种青霉素结合蛋白有更高的亲和力。故临床用于院内中、重度感染的治疗有较好的疗效。…     

头孢吡肟治疗社区获得性肺炎的临床疗效分析

目的探讨头孢吡肟治疗社区获得性肺炎的的临床效果及安全性。方法对2007年12月至2009年6月新疆医科大学第五附属医院综合内科收治60例患者采用单盲、随机对照试验研究。将60例随机分为头孢吡肟治疗组(31例)及莫西沙星对照组(29例);所有研究均以7～10d为一个疗程。观察治疗组与对照组的临床疗效、不良反应。结果治疗组和对照组的临床有效率分别为90.3%和58.6%,不良反应发生率头孢吡肟高于莫西沙星(25.8%对24.1%),差异无统计学意义(P0.05),主要不良反应为消化道症状及头痛。结论头孢吡肟是治疗社区获得性肺炎安全有效的药物。     

头孢吡肟对COPD合并下呼吸道感染的疗效评价

目的探究并分析头孢吡肟对COPD合并下呼吸道感染的疗效。方法选取我院收治的COPD合并下呼吸道感染患者100例,作为临床研究对象。随机分为观察组和对照组,每组50例。观察组患者给予头孢吡肟治疗,对照组患者给予第三代头孢类头孢曲松钠进行治疗。观察患者的临床疗效、不良反应,并比较两组患者体内病菌清除所需的平均时间。结果治疗后,观察组的总有效率为94.00%,明显高于对照组患者的68.00%;头孢吡肟的不良反应总发生率为4.00%,明显低于头孢曲松钠;观察组彻底清除体内病菌所需平均治疗时间明显少于对照组,P<0.05。结论头孢吡肟对于COPD合并下呼吸道感染的患者具有显著的疗效,且不良反应发生率低。     

头孢吡肟治疗下呼吸道细菌感染的临床评价

头孢吡肟 (Cefepime,CFP,商品名马斯平 )是美国施贵宝公司研制的第四代头孢菌素 ,其特点是对细菌产生的 β-内酰胺酶更加稳定 ,对革兰氏阳性菌作用较强。我们应用头孢吡肟治疗下呼吸道感染 3 6例 ,随机以头孢他啶 (Ceftazidine,CTZ)为临床对照。现报告如下。1　资料与方法1 .1　一般资料　本组下呼吸道细菌感染者共 72例。随机分为两组 ,每组各 3 6例。CFP组男 2 0例 ,女1 6例 ;年龄 5 8± 1 7岁。其中肺炎 1 8例 ,慢性支气管炎 1 5例 ,支气管扩张 3例 ;CTZ组 :男 1 8例 ,女 1 8例 ;年龄 5 7± 1 5岁。其中肺炎 1 4例 ,慢性支气管炎1 …     

头孢吡肟治疗社区获得性重症肺炎临床观察

目的观察头孢吡肟治疗社区获得性重症肺炎的临床治疗效果。方法选取我科室2015年5月~2016年12月接诊的58例社区获得性重症肺炎患者随机分成研究组(29例)和对照组(29例),研究组给予头孢吡肟治疗,对照组给予莫西沙星治疗,对比两组患者的治疗效果。结果研究组治疗效果好于对照组(P0.05),两组间不良反应对比没有统计学意义(P0.05)。结论头孢吡肟治疗社区获得性重症肺炎临床效果理想,值得临床推广应用。     

肺结核合并感染患者感染细菌及药敏情况分析

目的了解肺结核病人合并感染的细菌分离谱和耐药现状,为临床经验选择抗生素提供依据;方法采用纸片扩散法对痰标本进行药敏试验;结果 340株细菌分离菌分布:革兰氏阳性菌(9.71%),革氏阴性菌(40.59%),以白色念珠菌为主的真菌类占(49.71%)。药敏提示,亚胺培南、头胞他定、派拉西林/Tazo、头孢吡肟、环丙沙星耐药率较低。结论肺结核合并感染患者往往以革兰氏阴性菌为主,临床上可以根据患者病情轻重,经验选择亚胺培南、头胞他定、哌拉西林/他唑巴坦、头孢吡肟、环丙沙星、阿米卡星、头孢西丁、第2、3代头孢菌素等。肺结核患者合并感染的病原菌构成以G-杆菌和真菌为主,对多药耐药性较高,临床医生应根据药敏结果选择合理的抗菌药物     

奥硝唑注射液与头孢吡肟存在配伍禁忌

奥硝唑是继甲硝唑、替硝唑之后的第3代硝咪唑类衍生物,该药抗菌、杀虫活性高,体内半衰期长,组织渗透性好,不良反应较小,临床广泛用于治疗由厌氧菌、阿米巴原虫、贾滴虫、毛滴虫等引起的感染,对于严重混合感染常与头孢类抗生素等药物联合应用。头孢吡肟为广谱第4代头孢菌素,具有强大的广谱抗菌作用,通过抑制细菌细胞壁的生物合成而杀菌,     

头孢吡肟致老年痴呆尿毒症患者抗生素性脑病1例

头孢吡肟（cefepime）是半合成第4代头孢类抗生素,与前3代头孢菌素相比,它具有抗菌谱广、杀菌力强、不良反应少的优点。但该药主要由肾脏排泄,对于尿毒症患者,尤其是老年患者,易导致血液中药物或其代谢产物蓄积,致神经系统损害而发生抗生素性脑病。而抗生素性脑病的症状不典型,容易与其他疾病所致脑病混淆,临床上需仔细鉴别。现将上海市同济医院1例老年痴呆合并尿毒症患者应用头孢吡肟致抗生素性脑病的病例报道如下。     

厄他培南治疗中重度社区获得性肺炎疗效观察

目的 比较厄他培南与头孢曲松、头孢吡肟治疗中重度社区获得性肺炎的疗效.方法 回顾性研究解放军总医院呼吸科2010年11月至2012年5月中重度社区获得性肺炎患者,治疗组给予厄他培南(默沙东公司)1 g(1次/d),对照组为头孢曲松(沪罗氏)2 g(1次/d),头孢吡肟(施惠宝)2 g(2次/d).比较两组治疗的有效率、治疗中炎性因子的变化情况及用药天数、住院天数等.结果 厄他培南组32例,治疗有效率为96.9％,头孢曲松组治疗有效率为75.0％,头孢吡肟组治疗有效率为73.1％,三组间差异有统计学意义(P＜0.05).结论 厄他培南比头孢曲松、头孢吡肟能更好地改善临床症状,有突出的临床疗效,安全性高,不良反应小,是治疗中重度社区获得性肺炎的理想选择.     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.     

Severe hepatotoxicity with jaundice associated with paroxetine

Hepatotoxicity due to paroxetine, a selective serotonin reuptake inhibitor, is very rare, and to the best of our knowledge, only five cases of liver injury in association with paroxetine have previously been reported in the medical literature. We describe the clinical, biochemical, and pathological findings in a patient with paroxetine hepatotoxicity, which was reversed after withdrawal of the drug. The present case and the others previously reported suggest that hepatotoxicity should be taken into account as a rare complication, sometimes severe, that may occur with paroxetine.