临床误诊误治
臨床誤診誤治
림상오진오치
Clinical Misdiagnosis & Mistherapy
2015年
10期
62-65
,共4页
克林霉素%药物毒性%急性肾损伤%数据收集
剋林黴素%藥物毒性%急性腎損傷%數據收集
극림매소%약물독성%급성신손상%수거수집
Clindamycin%Drug toxicity%Acute kidney injury%Data collection
目的：调查了解国内克林霉素致急性肾损伤( acute kidney injury, AKI)的现状,为临床医师合理用药提供参考依据。方法以“克林霉素+AKI或药物不良反应”为检索式,检索中国知网2010—2014年中文医学期刊中克林霉素导致AKI的相关文献,对符合标准的文献进行信息记录并采用Excel软件进行数据统计汇总和分析。结果共纳入文献23篇425例患者；首发症状均为恶心、呕吐、乏力、腰腹部疼痛并伴有肉眼血尿甚至酱油样尿；原发疾病多为上呼吸道感染,其次为胃肠炎、牙龈炎、咽炎等；给药途径均为静脉滴注；用药剂量0.9~2.7 g/d,输注浓度6~12 g/L；部分联合用药；AKI发生时间：用药后20 min~7 d。确诊后经停药、对症处理,并酌情给予血液透析治疗,424例痊愈,肾功能恢复正常时间7~150 d；1例因急性肾衰竭死亡。结论克林霉素致AKI几乎均发生于静脉滴注时,发病时间集中在用药后20 min~7 d,引发原因与个体、用药剂量浓度等诸多因素有关。提示临床医师应谨慎按照药品说明书给药,给药过程中应严密观察患者尿量及肾功能变化,以及早发现AKI。
目的：調查瞭解國內剋林黴素緻急性腎損傷( acute kidney injury, AKI)的現狀,為臨床醫師閤理用藥提供參攷依據。方法以“剋林黴素+AKI或藥物不良反應”為檢索式,檢索中國知網2010—2014年中文醫學期刊中剋林黴素導緻AKI的相關文獻,對符閤標準的文獻進行信息記錄併採用Excel軟件進行數據統計彙總和分析。結果共納入文獻23篇425例患者；首髮癥狀均為噁心、嘔吐、乏力、腰腹部疼痛併伴有肉眼血尿甚至醬油樣尿；原髮疾病多為上呼吸道感染,其次為胃腸炎、牙齦炎、嚥炎等；給藥途徑均為靜脈滴註；用藥劑量0.9~2.7 g/d,輸註濃度6~12 g/L；部分聯閤用藥；AKI髮生時間：用藥後20 min~7 d。確診後經停藥、對癥處理,併酌情給予血液透析治療,424例痊愈,腎功能恢複正常時間7~150 d；1例因急性腎衰竭死亡。結論剋林黴素緻AKI幾乎均髮生于靜脈滴註時,髮病時間集中在用藥後20 min~7 d,引髮原因與箇體、用藥劑量濃度等諸多因素有關。提示臨床醫師應謹慎按照藥品說明書給藥,給藥過程中應嚴密觀察患者尿量及腎功能變化,以及早髮現AKI。
목적：조사료해국내극림매소치급성신손상( acute kidney injury, AKI)적현상,위림상의사합리용약제공삼고의거。방법이“극림매소+AKI혹약물불량반응”위검색식,검색중국지망2010—2014년중문의학기간중극림매소도치AKI적상관문헌,대부합표준적문헌진행신식기록병채용Excel연건진행수거통계회총화분석。결과공납입문헌23편425례환자；수발증상균위악심、구토、핍력、요복부동통병반유육안혈뇨심지장유양뇨；원발질병다위상호흡도감염,기차위위장염、아간염、인염등；급약도경균위정맥적주；용약제량0.9~2.7 g/d,수주농도6~12 g/L；부분연합용약；AKI발생시간：용약후20 min~7 d。학진후경정약、대증처리,병작정급여혈액투석치료,424례전유,신공능회복정상시간7~150 d；1례인급성신쇠갈사망。결론극림매소치AKI궤호균발생우정맥적주시,발병시간집중재용약후20 min~7 d,인발원인여개체、용약제량농도등제다인소유관。제시림상의사응근신안조약품설명서급약,급약과정중응엄밀관찰환자뇨량급신공능변화,이급조발현AKI。
Objective To investigate of clindamycin induced acute kidney injury ( acute kidney injury, AKI) , and to provide reference basis for rational use of drugs. Methods The adverse reactions of clindamycin and AKI or drugs were as the search type. CNKI during 2010 and 2015 about clindamycin leading to AKI was retrieved, and literature of a total of 23 ar-ticles was included. Summary and analysis of all the information were recorded in the Excel software. Results Clindamycin resulted in a total of 425 cases of AKI;primary diseases of the patients were upper respiratory tract infection, gastroenteritis, gingivitis, pharyngitis, bronchiectasis with infection, otitis media and so on; route of administration was intravenous drip;dose 0. 9-2. 7 g/d, concentration 6-12 mg/ml;AKI occurred at 20 min-7 d after administration. All the patients stopped using clindamycin, after confirmed diagnosis and symptomatic treatment was given. 424 cases were cured. Renal function recovered 7-150 d;1 patient died of acute renal failure. Conclusion Almost all cases of AKI occurred during clindamycin intravenous drip, the onset time is 20 min-7 d after administration. The cause is related to many factors, such as the individual and the dose of drug. Doctors are advised to follow the instructions carefully. In the course of administration, the physicians should observe the changes of urine volume and renal function closely, so as to detect AKI as early as possible.
