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目的:探讨尿毒症患者头孢菌素脑病的发病机制和临床特点。方法:对31例尿毒症头孢菌素脑病患者使用的头孢类药物及发病后治疗进行分析。结果:头孢菌素治疗尿毒症合并感染可引起脑病。第1、2、3代头孢菌素脑病有不同特点。第1代头孢菌素脑病多发生于用药剂量未作适当调整且未规则血透病人,发病后血透效果好。第3代头孢菌素脑病在血透病人也会发生,发生后血透疗效差,但停药后可自行缓解。第2代头孢菌素引起脑病,血透效果差,且不能自行缓解,预后最差。结论:尿毒症患者使用头孢菌素时应注意药物选择及剂量调整,发生脑病后应根据药物药理特点治疗。
Objective: To investigate the pathogenesis and clinical features of cephalosporin encephalopathy in patients with uremia. Methods: Cephalosporins used in 31 patients with uremic cephalosporin encephalopathy and post-morbid treatment were analyzed. Results: Cephalosporin treatment of uremic infection can cause encephalopathy. The first and second generation of cephalosporin encephalopathy have different characteristics. The first generation of cephalosporin encephalopathy occurred in the dosage has not been properly adjusted and irregular hemodialysis patients, hemodialysis effect is good. The third generation of cephalosporin encephalopathy in hemodialysis patients will occur, after hemodialysis effect is poor, but can relieve their own withdrawal. The second generation of cephalosporins cause encephalopathy, hemodialysis effect is poor, and can not relieve itself, the worst prognosis. Conclusion: The use of cephalosporins in patients with uremia should pay attention to drug selection and dose adjustment, the occurrence of encephalopathy should be based on the pharmacological characteristics of the treatment.