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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。
A 43-year-old woman with bronchiectasis was infused with ceftezole sodium 2.0 g and 0.9% sodium chloride 250 ml intravenously. After 5 h clindamycin 1.2 g was added to 10% glucose injection 500 ml intravenously. About 20 minutes intravenous infusion, patients with abdominal pain, frequent vomiting, gross hematuria. Immediately disable clindamycin, intramuscular injection of diclofenac sodium 50 mg, cimetidine 200 mg patients with abdominal pain relief. After giving clindamycin 3h to the next morning patients with anuria, and systemic edema. Renal function tests: urea nitrogen 17.6 mmol / L, creatinine 544μmol / L. Diagnosis of clindamycin-induced acute renal failure. Hemodialysis was performed on the 3rd and 6th day after admission. The urine output of the patients returned to normal with urea nitrogen 4.3 mmol / L and creatinine 65 μmol / L. Instillation of ceftezole sodium 2.0 g / d anti-infection, the patient reduced cough, purulent sputum disappeared, discharged on the seventh day.