β-内酰胺类抗生素致肺部重症感染患者神经系统不良反应的临床研究

Neurological Adverse Reactions in Patients with Severe Pulmonary Infection Caused by β-Lactam Antibiotics

摘要: 目的：探究β-内酰胺类抗生素致肺部重症感染患者神经系统不良反应的临床特点，以此提高防治水平。方法：回顾性分析2015年2月至2016年2月我院确诊的尿毒症并发肺部重症感染42例使用β-内酰胺类抗生素患者的临床资料，分析β-内酰胺类抗生素的品种、剂量及神经系统不良反应的临床特征。结果：尿毒症并发肺部重症感染患者使用β-内酰胺类抗生素行抗感染治疗时易引发神经系统不良反应。神经系统不良反应表现多样，主要为兴奋多语、胡言乱语、神志恍惚、烦躁不安、嗜睡、反应迟钝、失眠及双上肢不自主震颤。患者停药或行血液灌流联合血液透析治疗后，神经系统不良反应均能基本完全消失，且无神经系统后遗症。结论：β-内酰胺类抗生素致尿毒症并发肺部重症感染患者神经系统不良反应较为常见，当患者出现神经系统不良反应时，及时停药，给予合适的治疗方案，不良反应症状能在短期内消失，且不会造成神经系统后遗症。

Abstract: Objective: To investigate the clinical features of neurological adverse reactions in patients with severe pulmonary infection caused by β-lactam antibiotics, so as to improve the control level. Me-thods: The clinical data of 42 patients with uremia complicated with severe pulmonary infection who were diagnosed in the hospital during the period from February 2015 to February 2016 and used β-lactam antibiotics were retrospectively analyzed. The variety and dosage of β-lactam anti-biotics and clinical features of neurological adverse reactions were analyzed. Results: Patients with uremia complicated with severe pulmonary infection were prone to having neurological adverse reactions during anti-infection treatment with β-lactam antibiotics. The neurological adverse reactions mainly included excitation and logomania, babble, trance, dysphoria, lethargy, slow response, insomnia and involuntary tremors of upper limbs. They almost completely disappeared after drug withdrawal or hemoperfusion and hemodialysis, without neurological sequelae. Conclusion: Neurological adverse reactions are common in patients with uremia complicated with severe pulmonary infection caused by β-lactam antibiotics. When patients have neurological ad-verse reactions, they should stop taking drugs and undergo appropriate treatment. The adverse reactions can disappear in a short term, without causing neurological sequelae.