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【目的】探讨头孢曲松致尿毒症患者脑病的临床特征及治疗方法。【方法】回顾性分析本院40例肾衰竭患者在使用头孢曲松（头孢曲松用量2～3 g／d）过程中出现的神经精神症状及脑电图表现，探讨其可行的治疗方案。【结果】40例患者均是在临床用药的过程中逐渐出现意识障碍以及定向力障碍等症状，停用头孢曲松抗生素后，行血液透析＋灌流治疗，3例应用抗癫痫药物，2～5 d后38例患者症状缓解，2例患者死亡（死于败血症）；36例患者行脑电图检查，28例脑电图显示背景为广泛慢波伴有中到高波幅尖波或者尖慢波。【结论】肾衰竭患者使用常规剂量的头孢曲松可引起神经毒性，推测可能与患者血脑屏障的改变、药物的清除率降低以及游离药物浓度增高有关。尿毒症患者在应用头孢曲松时需根据内生肌酐清除率调整剂量，一旦出现症状需及时停药并且立即行血液透析＋灌流治疗。“,”Objective]To explore the rational use of ceftriaxone in uremic patients .[Methods]A total of 40 pa‐tients with renal failure were retrospectively analyzed with regards to cephalosporin (2~3 g/d) causing mental symptoms and electroencephalogram (EEG) to explore the diagnosis and treatment .[Results]During medications , 40 patients had a gradual onset disturbed consciousness and disorientation .Upon a withdrawal of ceftriaxone , combined therapy of hemodialysis and perfusion was offered .Antiepileptic drugs were dosed in 3 cases .And the symptoms of 38 cases were relieved at Days 2 and 5 .Two patients died from sepsis .EEG was performed in 36 and 28 cases showed a background of wide slow wave with medium‐to‐high reflection amplitude wave or a sharp slow wave .[Conclusion]In renal failure patients ,regular doses of ceftriaxone causes nervous toxicity through altered blood brain barrier ,reduced clearance rate of drug and higher free drug concentrations .Thus using ceftriaxone in uremic patients requires dosage adjustment according to the endogenous creatinine clearance .Once the symptoms should be timely withdrawal and line hemodialysis + perfusion treatment immediately .