头孢米诺钠致凝血功能障碍临床剖析.docVIP

PAGE  PAGE 6 通讯作者：穆静，主治医师，Tel：01083912504，E-mail：mjmjh22@ 高龄患者应用头孢米诺钠致凝血功能障碍 穆静 安磊 王晓伶 杨玲（北京回民医院神经内科，北京 100054） 【摘要】 目的：调查老年高龄患者应用头孢米诺钠致凝血功能障碍的临床特点，为合理使用头孢米诺钠提供依据。方法：回顾性分析2007年11月至2009年3月应用头孢米诺钠治疗后出现凝血功能障碍的5例老年高龄患者的临床资料。5例患者因下呼吸道感染入院，单独静脉滴注头孢米诺钠2~4g/d。记录患者凝血功能障碍出现时间、临床表现和转归，以及用药前后凝血功能指标、血小板、肝、肾功能和血钙的测定结果。结果：5例患者中男2例、女3例，年龄82~89岁，平均（86±2.6）岁，在静脉滴注头孢米诺钠5~12d，平均（8.4±2.6）d出现凝血功能障碍，表现为呕血、血尿、黑便、创面???血。经停药及对症治疗2例好转，3例死亡。5例患者用药前后比较，凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)用药后显著延长，凝血酶时间(TT)、纤维蛋白原(Fbg)、血小板、肝功能、肾功能、血钙差异均无统计学意义。结论：老年高龄患者静脉滴注头孢米诺钠可出现凝血功能障碍，并预后不良，高龄患者应用头孢米诺钠应注意监测凝血功能。 【关键词】头孢米诺钠；凝血功能障碍；高龄患者 Clinical analysis of coagulation disorders due to cefminox sodium in aged patients. Mu Jing. Department of Neurology ,Hui Min Hospital,Beijing 100054 ,China. 【Abstract】Objective By studying the clinical features of coagulation disorders due to cefminox in aged patients, provide basis of rational use of cefminox. Methods The clinical data of 5 aged patients with coagulation disorders after using cefminox from November 2007 to March 2009 were retrospectively analyzed. The 5 patients were hospitalized because of lower respiratory tract infection, and were singly intravenously infused of cefminox 2~4g/d. The recorded parameters included: presentation time of coagulation disorders, clinical manifestations, outcome, coagulation parameters, platelet, liver function, renal function, blood calcium before and after medication. Results We studied 5 patients [2men, 3 women, mean age (86±2.6) years,range 82~89 years]. The average presentation time of coagulation disorder was (8.4±2.6) days (range 5~12 days) after medication. The clinical manifestations included hematemesis, hematuria, melena, blood oozing from the wound surface. After drug withdrawal and symptomatic treatment, 2 patients improved, 3 died. Prepared with pre-medication, the prothrombin time(PT), activated partial thromboplastin time(APTT), international normalized ratio(INR) of post-medicat