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目的探讨尿毒症患者使用抗生素后引起尿毒症脑病的抗生素种类和临床特点,以指导抗生素在肾衰竭血液透析患者中的合理应用,为临床上的透析患者抗生素的使用提供建议和对策,为临床抗生素合理用药提供参考。方法回顾性分析2008年12月至2009年12月在抗生素治疗过程中出现神经精神症状的20例慢性肾衰竭透析治疗患者,并对其进行临床症状和用药情况的分析和统计。结果 20例患者均在5～12d出现神经精神症状,症状表现多样,所有患者均无神经系统定位体征,经颅脑CT检查无急性病变。所有患者经停药、改变剂量及继续透析治疗后症状完全消失。结论慢性肾功能衰竭血液透析患者使用抗生素可引起中毒性脑病,由于肾脏的排泄功能下降,故用药前应根据肾功能减退程度调整药物剂量,有条件者可进行血药浓度监测,用药过程中应密切观察,一旦出现症状及时停药及处理。
Objective To explore the types of antibiotics and clinical features of uremic encephalopathy caused by uremia in patients with uremia to guide the rational use of antibiotics in hemodialysis patients with renal failure and to provide suggestions and countermeasures for the use of antibiotics in clinical dialysis patients, Reasonable medication for reference. Methods A retrospective analysis of 20 patients with chronic renal failure who had neuropsychiatric symptoms during the course of antibiotic treatment from December 2008 to December 2009 was performed and their clinical symptoms and medication were analyzed and statistically analyzed. Results All 20 patients showed neuropsychiatric symptoms at 5 ~ 12 days. The symptoms were diverse. All patients had no signs of neurological localization and no acute lesions were detected by brain CT. All patients after stopping, changing the dose and continue dialysis treatment completely disappeared. Conclusion The use of antibiotics in patients with chronic renal failure hemodialysis can cause toxic encephalopathy. Because the excretion function of the kidneys is decreased, the dosage of drugs should be adjusted according to the degree of renal dysfunction before drug use. Blood concentration monitoring should be conducted if necessary. Close observation, in the event of symptoms and timely withdrawal and treatment.