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甲氰咪胍可抑制胃酸分泌,减少胃肠道出血.偶尔也用来治疗食道炎.现在还作为暴发性肝炎的常规用药.因其抑制了胃酸,使胃肠道念珠菌大量繁殖.在伴有肝衰的时候,细胞免疫功能受损,便引起念珠菌性败血症.过去对肝衰后细菌继发感染死亡或慢性免疫功能抑制而霉菌播散性感染已众所周知.但急性肝衰而合并霉菌性败血症,迄今尚未引起人们注意.作者报道三例用甲氰咪胍而引起的霉菌性败血症.一例55岁,有隐性肝硬变并作膝关节置换手术的病人.术后7天,情况恶化,出现四度肝昏迷.随即用庆大霉素、青霉素、灭滴灵、血浆灌注以及甲氰咪胍(200mg,日3次).但6天后死亡.尸体解剖见胃肠道广泛出血.食道粘膜糜烂,切片可见大量念珠菌芽孢和菌丝.在心、肾还发现霉菌性脓肿.例二,27岁,胫骨骨折复位手术后,急性肝、肾
Cimetidine can inhibit gastric acid secretion, reduce gastrointestinal bleeding, and occasionally used to treat esophagitis, now also used as a routine treatment of fulminant hepatitis because of its inhibition of gastric acid, gastrointestinal Candida bacteria multiply. When there is liver failure, cell immune function is impaired, it will cause candida septicemia .In the past, bacterial infection after liver failure or death caused by chronic immune suppression and mold disseminated infections are well known.But acute liver failure and mold Septicemia has so far not been noticed, and the authors report three cases of mold septicemia caused by cimetidine, a 55-year-old patient with a recessive liver cirrhosis who underwent knee replacement surgery.After 7 days, With four degrees of hepatic coma, then with gentamicin, penicillin, metronidazole, plasma perfusion and cimetidine (200mg, 3 times a day), but died after 6 days.The autopsy see extensive gastrointestinal bleeding .Easophageal Mucosal erosion, a large number of visible sections of Candida spores and mycelium in the heart, kidney also found fungal abscess .Second, 27 years old, tibia fracture reduction surgery, acute liver and kidney