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2例尿毒症血液透析患者(女,76岁和男,56岁)因呼吸道感染分别给予头孢吡肟1.0g,1次/12h静脉滴注。女患者用药第5天出现精神萎靡、反应迟钝、烦躁不安伴随认知功能障碍、失语等,ECG呈弥漫性慢波。男患者用药第3天出现恶心、呕吐,烦躁、肌阵挛、言语迟缓、反应迟钝和精神错乱。此外,2例患者脑CT均未见明显改变。考虑患者神经系统不良反应与使用头孢吡肟有关。因此,停用头孢吡肟,继续行血液透析。随后患者的神经精神不良反应消失出院。
Two patients with uremia hemodialysis (female, 76 years old and male, 56 years old) were given cefepime 1.0g and 1 / 12h intravenously for respiratory tract infection respectively. On the fifth day of treatment, the female patient showed apathetic, unresponsive, restlessness accompanied by cognitive dysfunction, aphasia, etc. The ECG showed diffuse slow wave. Male patients on the 3rd day of treatment with nausea, vomiting, irritability, myoclonus, speech slow, unresponsive and insanity. In addition, two patients had no significant change in brain CT. Consideration of adverse reactions in patients with nervous system and the use of cefepime. Therefore, discontinue cefepime and continue hemodialysis. Then the patient’s neuropsychiatric adverse reactions disappeared from the hospital.