β-内酰胺类抗生素致血液透析患者神经系统不良反应

目的 探讨β-内酰胺类抗生素在肾功能衰竭血液透析中的合理应用.方法 回顾性分析我院13例肾功能衰竭血液透析的患者应用β-内酰胺类抗生素时引起的神经精神症状及相关临床资料.结果 患者于开始透析后或维持透析期间均出现神经精神症状,神经精神症状表现多样:神志恍惚,兴奋多语或语无伦次,嗜睡,其中2例伴有肌肉震颤.均无神经定位症状,其中7例经头颅CT检查,均未发现急性颅脑病变.所有患者停药后继续血液透析或血液透析滤过治疗后症状消失.结论 肾功能衰竭血液透析患者使用常规剂量的β-内酰胺类抗生素可引起一过性的脑病,与药物半衰期延长有关.     

21例老年患者抗生素相关性脑病临床分析

目的 探讨老年患者发生抗生素相关性脑病的临床特点.方法 总结2010年1月至2020年12月福建省老年医院21例抗生素相关性脑病老年患者的临床资料,对其使用抗生素的种类、用药至出现精神症状时间、临床表现及治疗转归进行回顾性分析.结果 使用抗生素的141例患者中,有21例患者在使用抗生素1～11d后出现不同程度脑病.不同抗生素的使用,所表现出的临床特点各异,患者停止使用抗生素后,神经精神症状完全消失.结论 老年患者在使用抗生素治疗期间,出现神经精神症状应警惕抗菌药物相关性脑病,应及时停药.     

慢性肾功能衰竭抗生素脑病临床分析

目的探讨慢性肾功能衰竭(chronic renal failure,CRF)抗生素脑病的临床特点及诊治措施。方法对我院2008年1月—2014年7月收治的CRF抗生素脑病12例的临床资料进行回顾性分析。结果 12例均为CRF,均按常规剂量使用β-内酰胺类抗生素,但未根据肌酐清除率调整剂量。使用抗生素2~12 d后出现兴奋、失眠、幻听、幻视及坐立不安6例,四肢震颤及癫痫样发作3例,胡言乱语及语无伦次2例,昏迷1例;12例神经系统检查均无定位体征,均符合CRF抗生素脑病诊断标准,确诊为CRF抗生素脑病。立即停用相关抗生素,给予血液透析联合血液灌流治疗,病情缓解。结论β-内酰胺类抗生素可导致CRF患者发生抗生素脑病,临床应高度警惕。血液透析联合血液灌流治疗抗生素脑病效果确切。     

尿毒症血液透析患者发生抗生素相关脑病的临床分析

目的 探讨尿毒症血液透析患者应用抗生素治疗后并发抗生素相关脑病的临床特点,以及预防和治疗的分析。方法 回顾性分析我院2013年1月至2020年1月期间16例尿毒症血液透析患者发生抗生素相关性脑病的临床特点,分析其发生抗生素脑病的相关因素及应对策略。结果 16例维持性血液透析患者因各种感染原因住院治疗,其中肺部感染8例;尿路感染1例;肾积脓1例;慢性支气管炎肺气肿急性发作3例;导管相关性感染1例;内瘘感染1例;急性阑尾炎1例。使用的抗生素主要有头孢哌酮舒巴坦、头孢哌酮他唑巴坦、头孢米诺、头孢他啶、左氧氟沙星、莫西沙星。使用抗生素后发生抗生素相关脑病,经停药给于苯巴比妥及血液透析滤过后,精神异常、抽搐等症状消失。结论 尿毒症血液透析患者,使用头孢菌素或喹诺酮抗生素后易发生抗生素脑病,抗生素的使用剂量和时间与患者癫痫等脑病症状发生有一定的相关性,明确诊断后应及时对症处理,可以考虑血液透析滤过及血液灌流治疗。     

血液透析治疗肾功能不全患者抗生素相关性脑病的护理

目的 探讨血液透析治疗肾功能不全患者抗生素相关性脑病的观察与护理要点.方法 收集5例应用抗生素引起脑病的肾功能不全患者,对维持性血液透析患者加强血液透析治疗,未透析患者予以血液透析治疗,透析过程中做好精心的护理.结果 5例患者意识状态均恢复正常、神经系统症状消失,1例停止血液透析,4例过度到维持性血液透析.结论 血液透析对治疗抗生素相关性脑病效果良好,而精心的护理可以使患者早日康复.     

血液透析治疗肾功能不全患者抗生素相关性脑病的护理

目的探讨血液透析治疗肾功能不全患者抗生素相关性脑病的观察与护理要点。方法收集5例应用抗生素引起脑病的肾功能不全患者,对维持性血液透析患者加强血液透析治疗,未透析患者予以血液透析治疗,透析过程中做好精心的护理。结果5例患者意识状态均恢复正常、神经系统症状消失,1例停止血液透析,4例过度到维持性血液透析。结论血液透析对治疗抗生素相关性脑病效果良好,而精心的护理可以使患者早日康复。     

慢性肾功能衰竭并发抗生素脑病19例

回顾 1995年 1月～ 2 0 0 4年 1月门诊及住院 2 73例慢性肾功能衰竭 (肾衰 )患者 ,2 2例中、大剂量应用 β 内酰胺类抗生素 ,19例并发抗生素脑病 ,主要表现为精神异常和抽搐昏迷。严格掌握适应证 ,合理减量使用 β 内酰胺类抗生素 ,及时停药和及时充分透析是治疗关键。     

抗生素致慢性肾衰竭患者药物性脑病38例临床分析

目的探讨引起慢性肾衰竭患者药物性脑病的抗生素种类、发病机制、临床特点及防治措施。方法回顾性分析发生药物性脑病38例慢性肾衰竭患者所使用的抗生素种类、临床特点、治疗及转归。结果头孢菌素类、喹诺酮类、碳青霉烯类可致药物性脑病,并与其药代动力学特点及给药剂量有关。停药和加强血液透析,绝大多数预后良好。结论 慢性肾衰竭患者应根据肾功能损害程度及药代动力学特点合理选择抗生素种类及调整给药剂量,加强不良反应监测,进行血药浓度监测。并发药物性脑病后要及时停药及强化透析治疗。     

头孢类抗生素致急性肾功能衰竭1例的护理体会

随着医药科学的发展，抗生素的药物品种不断增加，药品更新换代快，头孢类药物层出不穷，头孢类药品的大量涌现，给患者带来了福音，治愈了无数感染或严重感染的患者。在临床上头孢类药品使用量巨大，居所有的临床用药之首。但因其不合理的使用，也发生了一些严重的不良反应，本文对2005年5月5日在使用头孢类抗生素用药过程中出现一例急性肾衰患者，经停用头孢类抗生素，改用青毒素，使用利尿合剂，补充血容量，纠正电解质，抗感染等治疗后病情逐渐好转。现报告如下：     

血液透析滤过救治39例尿毒症脑病临床分析

尿毒症脑病是是指尿毒症患者并发神经、精神异常，是急慢性肾功能衰竭患者的严重并发症之一，具有发病隐袭、病情危重、死亡率高的特点。早期发现，及时治疗，可及时改善症状，降低死亡率。我院应用血液透析滤过治疗39例尿毒症脑患者，疗效满意，现报告如下。     

血液透析对终末期肾病患者外周血β2-微球蛋白的影响

目的 通过检测血液透析前后β_2-微球蛋白(β_2-MG)的变化情况,探讨采用CA-HP130膜的生物相容性及如何避免β_2-微球蛋白在体内沉积,减少并发症的发生 方法 用酶免疫法检测使用CA-HP130膜进行血液透析的终末期肾病患者透析前后外周血β_2-MG水平。结果 实验组透析前β_2-MG水平(24.67±0.45mg/L),与对照组(24.89±0.34mg/L)差异无显著性(P>0.05),实验组透析后β_2-MG水平(20.53±0.34mg/L)明显低于透析前水平(P相似文献   

红细胞生成素在血液透析中的应用评价——附46例报告

目的：观察重组人红细胞生成素（rHuEPO)用于血液透析贫血患者的疗效及不良反应。方法：46例慢性维持血液透析患者应用rHuEPO治疗3个月，观察血红蛋白、血细胞比容、生活质量等变化及不良反应。结果：治疗后患者的血红蛋白、红细胞数、血细胞比容均显著升高，生活质量明显改善。44例出现血压升高，需加大降压药物的剂量，4例死于脑出血，1例死于肺部感染，1例死于心力衰竭。结论：使用rHuEPO有助于改善血液透析患者的贫血状况，但治疗的同时需注意其血压升高、血液黏度增加不良反应。     

尿毒症患者抗生素脑病23例临床分析

目的探讨尿毒症患者使用抗生素过程中出现尿毒症脑病的临床特点。方法对使用抗生素治疗过程中出现神经精神症状的23例尿毒症维持性血液透析患者进行临床和用药情况分析。结果 23例患者在使用抗生素3～15天后出现神经精神症状,无神经定位体征。给予停药、加强血液透析治疗后,所有患者症状均完全消失。结论尿毒症患者在使用抗生素过程中易出现抗生素脑病,早期诊断、及时停药、加强透析治疗一般可恢复。     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.     

The nervous system adverse effect induced by β-lactam antibiotics in patients on hemodialysis

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.