临床误诊误治2016，Vol.29Issue(5)：63-68,6.DOI:10.3969/j.issn.1002-3429.2016.05.023
万古霉素致急性肾损伤临床报告并文献复习
Vancomycin Associated Acute Kidney Injury:A Case Report and Literature Review
杨萌萌 1周飞虎 1赵妍 1潘亮 1王黎 1胡新 1康红军1
作者信息
- 1. 100853 北京，解放军总医院重症医学科
- 折叠
摘要
Abstract
Objective To discuss the clinical characteristics , prophylaxis and therapy of Vancomycin associated a-cute kidney injury in order to improve the understanding about Vancomycin associated acute kidney injury .Methods Clinical data of a patient admitted to our department for Vancomycin associate acute kidney injury was retrospectively analyzed and re -lated literature was reviewed .Results The patient was admitted to the department of orthopedics in our hospital for congenital hip dislocation on the right side and right hip osteoarthritis .He received a total hip artificial joint replacement underwent right proximal femoral osteotomy surgery , which was accomplished successfully under epidural anesthesia , and the preoperative liver and renal functions were at normal levels .Then Vancomycin 1 g bid combined with Ceftriaxone 2 g qd were given for anti-in-fection and Rivaroxaban tablets of 5 mg qd used as anticoagulant .On day 3, the patient developed clinical symptoms including oliguria, thirst, nausea, vomiting and irritability.Concentrations of serum creatinine and urea nitrogen were simultaneously in -creased significantly .Due to these complications ,the diagnosis was drug-induced acute kidney injury , antibiotics and anticoag-ulants were discontinued and Vancomycin level was much higher than normal .On postoperative day 4, the patient was trans-ferred to department of critical care medicine because his condition became worse .With continous renal replacement therapy ( CRRT) and other symptomatic treatment , the patient recovered gradually .Conclusion Clinicians should be vigilant about nephrotoxicity in the process of application of Vancomycin .If the symptoms of acute kidney injury occur without explainable reasons, its side effects of nephrotoxicity should be taken into consideration .Monitoring concentration of the drug , discontinu-ing infusion in time and initiating CRRT as early as possible are effective measures to recover renal function of the patients .关键词
万古霉素/药物毒性/急性肾损伤Key words
Vancomycin/Drug toxicity/Acute kidney injury分类
医药卫生引用本文复制引用
杨萌萌,周飞虎,赵妍,潘亮,王黎,胡新,康红军..万古霉素致急性肾损伤临床报告并文献复习[J].临床误诊误治,2016,29(5):63-68,6.
