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患者男性,67a因大咯血4d于1997年3月7日入院.住院Wk1用头孢唑啉钠2.5g iv gtt bid,同时用云南白药、止血敏等对症处理,但仍有咳嗽,痰中带鲜血,于3月11日再次整口咯血40余毫升.当时检查凝血三项及肝肾功能等均正常,患者食欲尚好,无恶心、呕吐,便常规及潜血阴性.于3月14日改用乳酸环丙沙星注射液(北京制药厂,批号96040911)200mg iv gtt bid,后续常规液体(以iv gtt 8d)10%葡萄糖液500ml加15%氯化钾8ml.在第1次iv gtt环丙沙星0.5h后患者出现寒战,腰及双下肢关节酸痛难忍.经用非那根25mg im后症状缓解;但第2至第5次iv gtt环丙沙星均有上述症状,并出现恶心、呕吐,体温高达39～40℃,四肢关节无红肿,曾两次血培养阴性,体温呈双峰,iv gtt环丙沙星后体温明显升高,对症处理后体温降到37℃.考虑系该药的不良反应,停用乳酸环丙沙星,其他维持液不变,改用头孢唑啉钠2.5g iv gtt bid,未再出现上述症状.但患者精神萎靡,以步行入院变为卧床不起,食欲减退,不厌油腻,听力下降,耳鸣,双球结膜充血,巩膜黄染,全身皮肤黄染加重,无皮疹及皮下出血,双肺无喘鸣音,肝不大,肝区及肾区无叩击痛,但抽血实验室检查发现肝肾功能均明显损害,血象异常.
Male patients, 67a due to massive hemoptysis 4d admitted to hospital on March 7, 1997. Wk1 with cefazolin sodium 2.5g iv gtt bid, while Yunnan Baiyao, bleeding and other symptomatic treatment, but there is still cough, sputum with blood , Again in March 11 whole mouth more than 40 ml of hemoptysis.At that time, check blood coagulation and liver and kidney function are normal, the patient appetite is good, no nausea, vomiting, routine and occult blood negative .In March 14 to use lactic acid Ciprofloxacin injection (Beijing Pharmaceutical Factory, lot number 96040911) 200mg iv gtt bid, followed by conventional liquid (iv gtt 8d) 10% glucose solution 500ml plus 15% potassium chloride 8ml in the first iv gtt ciprofloxacin Star 0.5h after the patient chills, waist and lower extremity joint pain unbearable. After using phenazon 25mg im symptom relief; but the second to the fifth iv gtt ciprofloxacin have the above symptoms, and nausea, Vomiting, body temperature as high as 39 ~ 40 ℃, limbs and joints without swelling, negative blood culture twice, the body temperature showed a double peak, iv gtt ciprofloxacin significantly increased body temperature, symptomatic treatment after body temperature dropped to 37 ° C. Drug adverse reactions, disable the ciprofloxacin lactate, the other maintenance solution unchanged, switch to cefazolin sodium 2.5g iv gtt bid, did not recur above However, patients with apathetic to walk into hospital into bedridden, loss of appetite, greasy tired, hearing loss, tinnitus, conjunctival hyperemia, scleral yellow dye, systemic yellow skin dye aggravating, no rash and subcutaneous bleeding, lungs No wheezing, liver is not large, liver and kidney area without percussion pain, but blood tests found liver and kidney function tests were significantly impaired, abnormal blood.