羟乙基淀粉致过敏性休克死亡

患者女,40岁。因药物过敏性休克,于2006年1月20日入院。既往无药物过敏史。入院前10d在当地县人民医院行急性阑尾炎手术切除术,术后即给予青霉素钠400万U+0.9%氯化钠注射液250ml,2次/d静脉滴注,5%葡萄糖注射液500ml+维生素C2g、维生素B6200mg、10%氟化钾10ml,1次/d静脉滴注,治疗5d术后切口不愈合,且发生感染,改用头孢曲松钠3g+0.9%氯化钠注射液250ml,2次/d静脉滴注,能量合剂支持治疗5d后,切口仍不愈合。因术后一直食欲差,考虑患者能量消耗大,加用羟乙基淀粉(706代血浆)500ml静脉滴注,当输液1min后,患者出现恶心、呼吸困难、胸闷、气憋、紫…     

鱼石脂软膏加压热敷治疗下肢慢性淋巴管炎1例

患者,男,86岁,退休工人,因"右下肢红、肿、疼痛20天"就诊。患者20天前因右下肢红、肿、疼痛去某省级医院就诊,诊断为"右下肢慢性淋巴管炎",给予"0.9%氯化钠注射液250ml+美洛西林4.0g,2次/d;0.9%氯化钠注射液250ml+左氧氟沙星0.3g,1次/d"输液治疗15d,但患肢症状始终未缓解,后改为"0.9%氯化钠注射液250ml+头孢哌酮钠2.0g,2次/d;0.9%氯化钠注射液100ml+硫酸依替米星注射液0.1g,2次/d"输液治疗4d,病情仍未     

头孢米诺钠与头孢唑肟钠序贯治疗ICU重症颅脑损伤患者肺部感染的疗效观察

目的:观察头孢米诺钠与头孢唑肟钠序贯治疗重症加强护理病房(ICU)重症颅脑损伤患者肺部感染的临床疗效及安全性。方法:选择108例ICU重症颅脑损伤并发肺部感染患者,随机均分为两组。所有患者首先均给予头孢米诺钠2 g,加入0.9%氯化钠注射液40 ml中静脉滴注,bid,治疗3 d,如出现好转,对照组患者继续给予头孢米诺钠静脉滴注,剂量减为1 g,bid;观察组患者改用头孢唑肟钠2 g,加入0.9%氯化钠注射液250 ml中静脉滴注,q8 h或q12 h,严重感染者剂量可增至3～4 g,两组患者均继续治疗4 d。监测两组患者治疗前后的血尿常规、丙氨酸氨基转移酶、总胆红素、尿素氮、血肌酐及X线胸片,观察两组患者临床疗效、细菌学疗效及不良反应情况。结果:观察组患者总有效率较对照组患者显著升高,差异有统计学意义(P<0.05);观察组患者细菌转阴率较对照组患者显著升高,差异有统计学意义(P<0.05);两组患者除个别出现轻度皮肤过敏反应和给药后丙氨酸氨基转移酶进一步升高外,未见其他明显不良反应发生。结论:头孢米诺钠与头孢唑肟钠序贯治疗ICU重症颅脑损伤患者肺部感染具有显著的临床疗效,可减少头孢米诺钠耐药性的产生,提高细菌转阴率,且安全性较好。     

头孢匹胺钠与奥硝唑注射液存在配伍禁忌

[病例]对我科手术后患者我们常将注射用头孢匹胺钠2.0 g加入0.9%氯化钠注射液100 ml中静脉滴注,每日2次;奥硝唑注射液0.5 g加入0.9%氯化钠注射液100 ml中静脉滴注,每日2次.但在输完头孢匹胺钠组液更换奥硝唑组液时,常可见莫菲滴管及输液器中出现白色絮状物,更换液体及输液器10 min后白色絮状物消失,观察患者病情,未发生不良反应.     

头孢匹胺钠与奥硝唑注射液存在配伍禁忌

[病例]对我科手术后患者我们常将注射用头孢匹胺钠2.0 g加入0.9%氯化钠注射液100 ml中静脉滴注,每日2次;奥硝唑注射液0.5 g加入0.9%氯化钠注射液100 ml中静脉滴注,每日2次.但在输完头孢匹胺钠组液更换奥硝唑组液时,常可见莫菲滴管及输液器中出现白色絮状物,更换液体及输液器10 min后白色絮状物消失,观察患者病情,未发生不良反应.     

治疗多重耐药铜绿假单胞菌感染的临床探究

目的:探索治疗多重耐药铜绿假单胞菌感染的方法。方法:85例多重耐药铜绿假单胞菌呼吸道感染患者随机分为试验组与对照组。试验组给予磷霉素4g+5%葡萄糖注射液100mL静脉滴注完毕后60min立即给予头孢哌酮/舒巴坦4g+0.9%氯化钠注射液250mL静脉滴注,2次.d-1。对照组采用头孢哌酮/舒巴坦4g+0.9%氯化钠注射液250mL静脉滴注,2次.d-1,联合阿米卡星80mg+5%葡萄糖注射液250mL静脉滴注,1次.d-1。2组疗程均为14d。结果:试验组总有效率为93.02%,疗效优于对照组的42.86%(χ2=24.826,P=0.000)。结论:磷霉素+头孢哌酮/舒巴坦为治疗多重耐药铜绿假单胞菌感染的新途径。     

喷昔洛韦注射液治疗带状疱疹42例临床效果分析

目的探讨喷昔洛韦注射液治疗带状疱疹的临床治疗效果。方法选择我院2008年3月至2010年3月带状疱疹患者82例,将以上患者随机分为两组,观察组和对照组。观察组患者给予喷昔洛韦注射液0.25g+0.9%氯化钠注射液250ml静脉滴注,2次/d;对照组患者给予阿昔洛韦注射液0.5g+0.9%氯化钠注射液250ml生理盐水中静脉滴注,2次/d。两组患者均连续治疗7d。两组患者应用其他辅助用药均相同。对患者治疗前后临床症状评分,根据评分情况评估疗效。结果观察组总有效率与对照组总有效率比较,差异有统计学意义(P<0.05)。结论喷昔洛韦注射液能够显著改善带状疱疹患者临床症状,临床效果显著,值得借鉴。     

吉非替尼致视网膜出血

1例49岁男性患者因肺腺癌Ⅳ期接受化疗,具体方案为培美曲塞二钠0.8 g入0.9%氯化钠注射液100 ml静脉滴注、第1天,顺铂30 mg入0.9%氯化钠注射液250 ml静脉滴注、第1~4天,21 d为1个周期;同时给予靶向治疗,吉非替尼口服250 mg、1次/d。在第3个化疗周期停药第10天、服用吉非替尼第59天,...     

双黄连粉针剂引起肠绞痛2例

例1.女,30岁.因不慎受风寒致头痛,发热,咳嗽、四肢酸痛2d而前来我院就诊,查体:T 37.8℃,P 84次/min,R 22次/min,BP 90/60mm Hg(1mm Hg=0.133kPa),咽部微红.诊断为上呼吸道感染.既往身体健康,否认有药物过敏史.按医嘱给予:第1组:0.9%氯化钠溶液250ml+克林霉素粉针剂0.6g静脉滴注;第2组:5%萄糖注射液250ml+双黄连粉针剂(哈尔滨制药六厂生产)2.4g静脉滴注,第3组:5%萄糖注射液200ml +葡萄糖酸钙注射液10ml+维生素C 2g静脉滴注.     

克林霉素致腹痛、血尿及急性肾衰竭

1例43岁女性患者因支气管扩张合并感染,给予头孢替唑钠2.0 g加入0.9%氯化钠注射液250 ml静脉滴注。5 h后给予克林霉素1.2 g加入10%葡萄糖注射液500 ml静脉滴注。静滴约20 min时,患者出现腹痛、频繁呕吐、肉眼血尿。立即停用克林霉素,分别肌内注射双氯酚酸钠50 mg、西咪替丁200 mg后患者腹痛缓解。给予克林霉素3 h后至次日晨患者无尿,并出现全身水肿。肾功能检查:尿素氮17.6 mmol/L,肌酐544μmol/L。诊断为克林霉素所致急性肾衰竭。入院第3、6天行血液透析,患者尿量逐渐恢复正常,尿素氮4.3 mmol/L、肌酐65μmol/L。滴注头孢替唑钠2.0 g/d抗感染后,患者咳嗽减轻,脓痰消失,第7天出院。     

头孢米诺钠与2,4-二硝基苯酚的荷移反应及其测定

目的建立用荷移分光光度法测定头孢米诺钠含量的方法。方法利用头孢米诺钠与2,4-二硝基苯酚在甲醇-丙酮介质中反应,形成电荷转移络合物,采用分光光度法测定。结果荷移络合物在403nm处有最大吸收,表观摩尔吸光系数为=ε1.47×104L/(m o l.cm),药物浓度在4~40μg/m l范围内符合比耳定律线性关系,方法平均回收率大于97.0%。结论荷移分光光度法简便、准确、灵敏,可作为头孢米诺钠制剂的含量测定方法。     

头孢米诺高效液相色谱法含量测定

用高效液相色谱法，Ｃ１８柱，ｐＨ４．５醋酸铵缓冲液：甲醇（９１：９）为流动相，检测波长２７３ｎｍ，以扑热息痛作内标，测定头孢米诺的含量。在５０～５００μｇ／ｍｌ浓度范围内，浓度与峰面积线性关系良好（ｒ＝０．９９９９），注射剂的平均回收率为９９．６４％，重复进样相对标准偏差为０．２１％（ｎ＝７）。方法简便，准确。     

头孢米诺钠与酚磺乙胺的配伍稳定性

目的考察头孢米诺钠与酚磺乙胺在0.9%NS中配伍的稳定性。方法分别采用双波长分光光度法测定头孢米诺钠与酚磺乙胺配伍后,在25℃下放置0、2、4、6、8h两组分的含量,观察混合液的pH和外观的变化。结果头孢米诺钠与酚磺乙胺在0.9%NS中配伍后,在8h内含量及混合液pH均无显著变化。结论注射用头孢米诺钠与酚磺乙胺可配伍应用。     

Study on effects of cefminox sodium on blood coagulation system

Effects of cefminox (CMNX) on hemostasis and blood coagulation system were studied. Adult in-patients admitted to 237 centers (310 clinics) nationwide in Japan during the period from April 1988 to March 1989 were followed up using a newly designed uniformed protocol. Case cards recovered were inspected by an evaluation committee and patients to be included in analysis were determined according to the protocol. Presence or absence of abnormalities in the hemostasis and blood coagulation system was examined objectively using criteria for evaluation prepared by the committee. Out of 1,374 patients included in analysis, 10 patients were judged as having abnormalities which were suspected to have causal relationships with CMNX. Prolongation in prothrombin time was observed in 4 cases (0.29%), prolongation in activated partial thromboplastin time in 4 cases (0.29%), and decrease in fibrinogen in 2 cases (0.15%). Decrease in platelet count was not detected in any of the cases. Cross-sectional analysis according to background factors in these 10 cases revealed that abnormalities of the hemostasis and blood coagulation systems were significantly higher (P less than 0.01) for the group positive for underlying disease or complications ("positive" group) than the "negative" group. Five out of 9 patients of the positive group had malignant neoplasm. Other than this factor, no items showed statistically significant differences. From these results it is considered that the administration of CMNX is nearly free of effects on the hemostasis and blood coagulation system and development of laboratory abnormalities is chiefly due to the patients' condition.     

毛细管气相色谱法测定头孢米诺钠中几种有机溶剂残留量

目的:建立头孢米诺钠中几种有机溶剂残留量的测定方法.方法:采用毛细管气相色谱法,色谱柱为PEG-20M石英毛细管柱(30 m×0.53 mm,1.2μm),程序升温技术,用内标对比法分离测定头孢米诺钠中的残留溶剂.结果:建立的色谱方法对待测溶剂具有良好的分离度,在所考察的浓度范围内线性关系良好,各溶剂回收率在98.2%～100.4%,检测限1～3 ng.结论:该方法灵敏度、准确度均达到有机溶剂残留量的检测要求,可用于头孢米诺钠中残留有机溶剂的检测.     

头孢米诺钠对50例老年呼吸道感染的疗效

目的:评价头孢米诺钠对50例老年呼吸道感染的疗效及不良反应.方法:采用自身对照的方法考察用药后1,2wk的疗效.结果;治疗后与治疗前相比有明显差异,总有效率达90%.不良反应少,未见严重不良反应.结论:头孢米诺钠是治疗老年呼吸道感染的有效药物.     

Pharmacology of cefminox, a new bactericidal cephamycin

Cefminox is a new cephamycin antibiotic possessing a D-amino acid moiety derived from D-cysteine at the C-7B side chain. Cefminox is active against a wide range of bacteria, especially Gram-negative and anaerobic bacteria. Cefminox shows excellent in vivo efficacy (ED50) which is higher than would be expected from its in vitro activity (MIC). Moreover, cefminox possesses more potent activity in suppression of bacterial regrowth than other cephems. These phenomena are surmised to be caused by strong bactericidal activity which is attributed to a dual action mechanism.     

Clinical evaluation of cefminox in surgery

Cefminox (CMNX, MT-141) was administered to 7 cases with postoperative infections including subphrenic abscess and wound abscess, and the clinical effect was good in 2 cases, fair in 2, poor in 2 and unknown in 1. A daily dose was 2 g in 7 cases. The maximum total dose and duration were 22 g and 11 days respectively. Side effect which was observed during the test period was 1 case of drug eruption. No abnormal laboratory findings related to this drug were noted.     

Fundamental and clinical studies on cefminox

Cefminox (CMNX, MT-141) was tried in children with various infection and the following results were obtained. Serum levels and urinary recovery of CMNX were studied in 2 patients aged with 9 and 11 years. After intravenous injection of 20 mg/kg, the mean serum concentrations at 15, 30 minutes, 1, 2, 4, and 6 hours after the administration were 178.7, 122.2, 73.9, 41.0, 14.0 and 5.3 micrograms/ml, respectively. The half-life in serum was 1.36 hours. The average urinary recovery rate of CMNX was 86.5% at 6 hours after the administration. The therapeutic efficacy was excellent in 18, good in 1 and poor in 1 patient, the efficacy rate being 95%. As for the side effects, slight elevation of S-GOT and drug fever were observed in 2 cases.     

Laboratory and clinical studies on cefminox

Laboratory and clinical studies were performed on cefminox (CMNX, MT-141), a new cephamycin antibiotic, and results were as follows. Antimicrobial activities. MICs of CMNX against various clinical isolates were determined with the inoculum size of 10(6) cells/ml. Percentages of strains susceptible to 12.5 micrograms/ml or less were 4% for S. aureus, 0% for E. faecalis, 100% for E. coli, 81% for K. pneumoniae, 3% for Enterobacter sp., 18% for S. marcescens, 90% for P. mirabilis, 88% for indole-positive Proteus sp. 100% for S. flexneri, 100% for Salmonella sp., 0% for Citrobacter sp. and 0% for P. aeruginosa. Most of those sensitive strains were inhibited by 0.39-0.78 microgram/ml. These activities were better than those of cefmetazole and cefazolin, but were not as good as those of cefoperazone. Clinical efficacy Three patients with pneumonia, 1 with pneumonia and sepsis, and 1 with urinary tract infection were treated with CMNX daily dose of 1-4 g for 7-31 days. Clinical responses were excellent in 1, good in 3, poor in 2 patients (contained a double case). Bacteriological effects were good for E. coli, K. pneumoniae and S. liquefaciens, poor for P. aeruginosa and P. mirabilis. C. freundii, A. calcoaceticus and E. faecalis were cultured after treatment. No side effect and no abnormal change of laboratory findings were seen in our cases.