尿毒症患者抗生素脑病32例临床研究.doc

尿毒症患者抗生素脑病32例临床研究新疆库尔勒市第一人民医院，新疆库尔勒841000 【摘要】目的：探讨尿毒症患者使用抗生素后脑病发生原因、临床特点、转归，提高临床医师对该病的认识。方法：回顾性分析我院2007至2010年32例尿毒症患者应用头孢菌素过程中出现脑病的临床资料，分析脑病出现前后用药情况及转归。结果：男性14例，女性18例，年龄28-76岁，原发病：糖尿病肾病14例，慢性肾小球肾炎12例，高血压肾损害4例，多囊肾2例；维持血液透析26例，未透析者6例，从开始使用到出现抗生素脑病的时间为2-10天。停用抗生素，增加透析频率后症状改善。结论：肾功能不全患者抗生素脑病的发生率逐渐增加，一旦出现中枢神经系统症状，不要单纯考虑尿毒症脑病，应警惕抗生素脑病，及时停药处理非常重要。 【关键词】尿毒症；头孢菌素；抗生素脑病 【中图分类号】R747.9；R692.5【文献标识码】A文章编号：1004-7484（2012）-05-0825-01 Uremic patients with antibiotic encephalopathy : clinical analysis of 32 casesZHANG Ze-rong Department Outpatient Services，First Peoples Hospital of Korla，Korla 841000，China 【Abstract】Objective：Discussion on the use of antibiotics in patients with uremia encephalopathy causes，clinical features，fate，and raise clinician awareness of the disease.Methods：Retrospective analysis of 2007-2010 in 16 cases in our hospital in uremic patients with cephalosporin encephalopathy occurred during clinical data，analysis of encephalopathy occurred before and after drug use and prognosis.Results：Male 7 cases，females 9 cases，age 28-76sui，primary disease：diabetic nephropathy in 7 cases，6 cases of chronic Glomerular nephritis，hypertensive renal injury in 2 cases，autosomal dominant polycystic kidney disease 1； maintenance of hemodialysis in 13 cases，no analysis of 3 cases.From the start used to antibiotic encephalopathy appears time is 2-10 days.The antibiotic is stopped，increasing frequency symptomatic improvement after dialysis.Conclusion：Renal insufficiency patients with gradual increase in the incidence of antibiotic encephalopathy，in the event of the central nervous system symptoms，don’’t simply consider uremic encephalopathy，warned against antibiotic encephalopathy，timely withdrawal treatment is very important. 【Key words】Uremia；Cephalosporin；Antibiotic encephalopathy随着社会的发展，尿毒症病人逐渐增加，生存期逐渐延长，感染几率增加，临床上尿毒症患者抗生素使用逐渐增加，抗生素脑病的发生率也有逐年增多趋势，其易与尿毒症脑病、高血压脑病、急性脑血管病变混淆，本文分析了32例抗生素脑病发生及转归，以提高对该病的认识。1.临床资料 1.1一般资料：我院肾内科2007年2月至2010年10月共发生尿毒症患者使用抗生素所致脑病32例，男性14例，女性1