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1例53岁接受腹膜透析的女性肾功能不全患者,因腹膜透析相关性隧道炎入院。给予氨曲南3g静脉滴注,2次/d;万古霉素0.125g加入腹透液2000ml中腹腔注入,4次/d。次日患者出现心慌、胸闷、气短,颜面、颈、前胸皮肤出现充血性红斑并有针刺感。立即用新鲜透析液行腹腔灌洗,静脉给予地塞米松5mg,20min后症状缓解,次日充血性红斑消失。停用万古霉素,改用替考拉宁腹透治疗,氨曲南治疗同前,患者无不良反应,1周后出院。
A 53-year-old woman with renal insufficiency undergoing peritoneal dialysis was admitted to the hospital for peritoneal dialysis-related tunnel inflammation. Given aztreonam 3g intravenous infusion, 2 times / d; vancomycin 0.125g added to the peritoneal dialysis fluid 2000ml, 4 times / d. The next day the patient developed palpitation, chest tightness, shortness of breath, face, neck, chest skin congestion and erythema with acupuncture. Immediately with fresh dialysate peritoneal lavage, intravenous dexamethasone 5mg, 20min after the symptoms were relieved, the next day the congestive erythema disappeared. Vancomycin was discontinued and used instead of dipyridamole. Treated with aztreonam, there was no adverse reaction and patients were discharged after 1 week.