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青霉素为目前儿科临床最常用的抗生素之一,其副作用之一为引起青霉素脑病,现将我科1993年11月至12月连续发生青霉素脑病4例藏族患儿报告如下:临床资料:4例中男性3例,年龄3—6月,均为世居藏族,发病均为支气管肺炎(普通型),无特殊合并症.4例均除外颅内疾患,维生素B_1缺乏,维生素B_6缺乏和依赖症,低血糖,低钙,低血镁,高原缺血缺氧性脑病等所致抽搐.青霉素用量及用法:四例均超过60万/kg/日,均为静脉滴注每日二次,最小一例3月男婴,用了320万u/日,最大1例6月女婴,用了480万u/日,均每日两次.抽搐出现时间及方式:最短1例男性4月婴儿,用药后15分钟出现烦躁不安,口周变育,呼吸急促60次/分,两眼球凝视,四肢肌张力增高继之抽搐,及时处理约1分钟后停止,停用青霉素后未再抽搐.二例均在用青霉素后50分钟出现反应,并在次日再次使用青霉素后出现频繁抽搐3次和4次/日,及时处理停用青霉素后即消失,最长一次男性5月婴儿,青霉素静脉用420万u/日,用药1小时出现四肢抽搐,尖叫,两眼凝视,发绀,抽搐二次/日,及时处理,停用青霉素,改用氨苄青霉素后未再抽搐,四例均痊愈出院.
Penicillin is currently one of the most commonly used pediatric clinical antibiotics, one of its side effects is caused by penicillin encephalopathy, now our department in November 1993 to December consecutive penicillin encephalopathy in 4 cases of children with children reported as follows: Clinical data: 4 cases There were 3 males, ranging in age from 3 to 6 months, all of whom were native Tibetans, with bronchopneumonia (common type) and no special complications, except for 4 cases of intracranial disease, vitamin B_1 deficiency, vitamin B_6 deficiency and dependency, Hypoglycemia, hypocalcemia, hypomagnesemia, high altitude hypoxic-ischemic encephalopathy convulsions, etc .. Penicillin consumption and usage: four cases were more than 600,000 / kg / day, are intravenous infusion twice daily, a minimum of one case March baby boy, spent 3.2 million u / day, up to 1 case of June baby girl, spent 4.8 million u / day, are twice daily. Twitch appear time and manner: the shortest 1 male infant in April, medication 15 minutes after the restlessness, perioral change, shortness of breath 60 times / min, staring at both eyes, limb muscle tension increased convulsions, and promptly stopped after about 1 minute, no penicillin withdrawal after convulsions. Penicillin 50 minutes after the reaction, and the next day after repeated use of penicillin frequent convulsions 3 times and 4 times / day, and Treatment of disabled penicillin disappeared, the longest a male May baby, penicillin vein with 4.2 million u / day, 1 hour medication appears limbs convulsions, screaming, staring, cyanosis, convulsions twice / day, timely treatment, Disable penicillin, use ampicillin after no convulsions, were cured four cases were discharged.