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随着庆大霉素在临床的广泛应用,其毒性亦日趋受到重视,尤其肾毒性在氨基糖苷类抗生素中占首位。我们自1981年以来收治因庆大霉素引起的急性肾功能衰竭病人12例,现报告并分析于下。临床资料12例中男女各6例,年龄18～75岁。原发病单纯肠道感染5例;再障、多发性骨髓瘤、糖尿病合并肠道感染、伤寒、胆道感染、胰头癌术后合并胆汁性腹膜炎、头部疖肿(该例肾活检为慢性肾炎)各1例。给药方法:11例静脉给药,1例肌注。用药剂量:80万u 一次性静脉投药1例;每日24万u 静脉给药,用1天4例,2天1例,3天2例;8万u 肌注,一日2次用2天1例;剂量不清3例。用药至少尿出现时间12小时～7天,平均2.5天。本组全部均为少尿型肾衰,少尿期持续时间3～20天,平均10天,全部病例均符合急性肾衰临床诊断标准。其中合并低钠血症4例,低钾血症4例,蛋白尿9例。
With the wide application of gentamicin in clinical practice, its toxicity has also been paid more and more attention. In particular, nephrotoxicity accounts for the first place among aminoglycoside antibiotics. We have treated 12 patients with acute renal failure due to gentamicin since 1981 and are reported and analyzed below. Clinical data of 12 cases of 6 men and women, aged 18 to 75 years. Primary disease of intestinal tract infection in 5 cases; aplastic anemia, multiple myeloma, diabetes mellitus infection, typhoid fever, biliary tract infection, pancreatic cancer with biliary peritonitis after surgery, head swelling (the case of chronic renal biopsy Nephritis) in 1 case. Methods of administration: 11 cases of intravenous administration, 1 case of intramuscular injection. Dose: 800000 u one-time intravenous administration in 1 case; daily 240000 u intravenous administration, with 1 day in 4 cases, 2 days in 1 case, 3 days in 2 cases; 80000 u intramuscular injection, 2 times a day with 2 Day 1 cases; 3 cases of unclear dose. Medication at least 12 hours to 7 days, an average of 2.5 days. This group are all oliguric renal failure, oliguria duration of 3 to 20 days, an average of 10 days, all cases are in line with the clinical diagnosis of acute renal failure criteria. Including hyponatremia in 4 cases, hypokalemia in 4 cases, 9 cases of proteinuria.