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2例老年女性患者(年龄80、74岁)分别因慢性支气管炎急性发作和皮肤感染给予阿莫西林-舒巴坦6.0 g加入0.9℅氯化钠注射液250 mL,1次/d静脉滴注。例1于次日出现尿频、尿痛、排尿困难,肉眼血尿2,4 h尿量约400 mL;实验室检查示尿蛋白(+),隐血(+++);BUN 8.48 mmol/L,SCr 380μmol/L。停用阿莫西林-舒巴坦,改为林可霉素,并给予保护肾功能及对症支持治疗。15 d后24 h尿量1 500 mL,BUN 5.86 mmol/L,SCr 116μmol/L,尿常规正常。例2在药物输注完毕后即出现恶心、呕吐、腰痛、血尿;尿蛋白(+++),隐血(++)。停用阿莫西林-舒巴坦,改用林可霉素。症状无好转2,4 h尿量不足200 mL,BUN 11.45 mmol/L,SCr 467μmol/L。行血液透析,林可霉素继续使用,并给予支持及对症治疗。治疗10 d后尿量逐渐增加,22 d后24 h尿量1 200 mL,BUN 7.83 mmol/L,SCr 141μmol/L,尿常规恢复正常。
Two elderly female patients (aged 80 and 74 years) were given amoxicillin-sulbactam 6.0 g due to acute exacerbation of chronic bronchitis and skin infections by adding 0.9 mL sodium chloride injection 250 mL intravenously once daily . Example 1 On the following day, urinary frequency, dysuria, dysuria, gross hematuria and urine volume were recorded at 2,4 h and about 400 mL respectively. Laboratory tests showed urinary protein (+) and occult blood (+++); BUN 8.48 mmol / L, SCr 380 μmol / L. Disable amoxicillin - sulbactam, changed to lincomycin, and given protection of renal function and symptomatic and supportive treatment. After 15 days, the urine output was 1 500 mL, BUN 5.86 mmol / L, SCr 116 μmol / L, urine routine was normal. Example 2 nausea, vomiting, back pain, hematuria after drug infusion; urinary protein (+++), occult blood (++). Stop amoxicillin - sulbactam, switch to lincomycin. No improvement in symptoms 2,4 h urine output of less than 200 mL, BUN 11.45 mmol / L, SCr 467μmol / L. Hemodialysis, lincomycin continue to use, and give support and symptomatic treatment. After 10 days of treatment, the urine output gradually increased. After 22 days, the urinary output was 1,200 mL, BUN 7.83 mmol / L and SCr 141μmol / L, and the urine routine returned to normal.