CAJ | 학술논문

1例73岁女性患者因结肠镜息肉切除术后预防感染,静脉滴注头孢孟多2.0g.输注完毕约2h,患者出现剧烈腹痛,给予解痉治疗未缓解;40 min后出现血白细胞减少(1.0×109/L),予丙帕他莫止痛,疼痛缓解.次日11:00患者突然出现血压降低[最低至80/50 mm Hg(1 mm Hg=0.133 kPa)]、心率加快,立即给予升压和补充血容量治疗.12:30再次静脉滴注头孢孟多2.0g,输注完毕后,患者出现休克,血压70/30 mmHg,并逐渐出现急性肾损伤、急性肺水肿,左心功能减低、肝损伤、血细胞减少、凝血功能障碍和弥散性血管内凝血.转入重症监护病房,经2周抢救治疗,患者病情逐渐好转.2个月后,除肾功能异常(血清肌酐165 μmol/L,尿素9.1 mmol/L)外,肝功能、凝血功能及血细胞等各项指标均恢复正常.
1례73세녀성환자인결장경식육절제술후예방감염,정맥적주두포맹다2.0g.수주완필약2h,환자출현극렬복통,급여해경치료미완해;40 min후출현혈백세포감소(1.0×109/L),여병파타막지통,동통완해.차일11:00환자돌연출현혈압강저[최저지80/50 mm Hg(1 mm Hg=0.133 kPa)]、심솔가쾌,립즉급여승압화보충혈용량치료.12:30재차정맥적주두포맹다2.0g,수주완필후,환자출현휴극,혈압70/30 mmHg,병축점출현급성신손상、급성폐수종,좌심공능감저、간손상、혈세포감소、응혈공능장애화미산성혈관내응혈.전입중증감호병방,경2주창구치료,환자병정축점호전.2개월후,제신공능이상(혈청기항165 μmol/L,뇨소9.1 mmol/L)외,간공능、응혈공능급혈세포등각항지표균회복정상.
A 72-year-old woman received an Ⅳ infusion of cefamandole 2.0 g for preventing infection after colonoscopic polypectomy.Two hours after infusion completion,the patient presented with severe abdominal pain and the symptom did not relieve after spasmolysis.At the next 11:00 am,she suddenly developed hypotension (the minimum level of 80/50 mm Hg) and elevated heart rate.Treatments for raising blood pressure and supplying blood volume were given immediately.At 12:30 am,an Ⅳ infusion of cefamandole 2.0 g was given again and,after infusion completion,she developed shock and a low blood pressure of 70/30 mm Hg.And she experienced gradually acute kidney injury,acute pulmonary edena,left heart dysfunction,liver damage,hypocytosis,coagulation disorders,and disseminated intravascular coagulation.The patient was admitted to intensive care unit and,after two-week resuscitation,her condition improved.Two months later,her hepatic function,coagulation function,and blood cells returned to normal except abnormal renal function (a serum creatinine level of 165 μmol/L and a urea nitrogen level of 9.1 mmol/L).