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1、高龄患者应用头孢米诺钠致凝血功能障碍穆静安磊王晓伶杨玲（北京回民医院神经内科，北京100054）【摘要】目的：调查老年高龄患者应用头孢米诺钠致凝血功能障碍的临床特点，为合理使用头孢米诺钠提供依据。方法：回顾性分析2007年11月至2009年3月应用头孢米诺钠治疗后出现凝血功能障碍的5例老年高龄患者的临床资料。5例患者因下呼吸道感染入院，单独静脉滴注头孢米诺钠2~4g/d。记录患者凝血功能障碍出现时间、临床表现和转归，以及用药前后凝血功能指标、血小板、肝、肾功能和血钙的测定结果。结果：5例患者中男2例、女3例，年龄82~89岁，平均（86±2.6）岁，在静脉滴注头孢
2、米诺钠5~12d，平均（8.4±2.6）d出现凝血功能障碍，表现为呕血、血尿、黑便、创面渗血。经停药及对症治疗2例好转，3例死亡。5例患者用药前后比较，凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)用药后显著延长，凝血酶时间(TT)、纤维蛋白原(Fbg)、血小板、肝功能、肾功能、血钙差异均无统计学意义。结论：老年高龄患者静脉滴注头孢米诺钠可出现凝血功能障碍，并预后不良，高龄患者应用头孢米诺钠应注意监测凝血功能。【关键词】头孢米诺钠；凝血功能障碍；高龄患者Clinicalanalysisofcoagulationdisordersd
3、uetocefminoxsodiuminagedpatients.MuJing.DepartmentofNeurology,HuiMinHospital,Beijing100054,China.【Abstract】ObjectiveBystudyingtheclinicalfeaturesofcoagulationdisordersduetocefminoxinagedpatients,providebasisofrationaluseofcefminox.MethodsTheclinicaldataof5agedpatientswithcoagulationdi
4、sordersafterusingcefminoxfromNovember2007toMarch2009wereretrospectivelyanalyzed.The5patientswerehospitalizedbecauseoflowerrespiratorytractinfection,andweresinglyintravenouslyinfusedofcefminox2~4g/d.Therecordedparametersincluded:presentationtimeofcoagulationdisorders,clinicalmanifestat
5、ions,outcome,coagulationparameters,platelet,liverfunction,renalfunction,bloodcalciumbeforeandaftermedication.ResultsWestudied5patients[2men,3women,meanage(86±2.6)years,range82~89years].Theaveragepresentationtimeofcoagulationdisorderwas(8.4±2.6)days(range5~12days)aftermedication.Thecli
6、nicalmanifestationsincludedhematemesis,hematuria,melena,bloodoozingfromthewoundsurface.Afterdrugwithdrawalandsymptomatictreatment,2patientsimproved,3died.Preparedwithpre-medication,theprothrombintime(PT),activatedpartialthromboplastintime(APTT),internationalnormalizedratio(INR)ofpost-
7、medicationwerestatisticallysignificantprolonged.NostatisticallysignificantdifferenceswerefoundinThrombintime(TT),Fibrinogen(Fbg),platelet,liverfunction,renalfunctionandbloodcalcium.ConclusionsIntravenousinfusionofcefminoxmayinducecoagulationdisordersinagedpatients,andtheprognosismaybe
8、bad.C
