摘要
结肠癌术前预防性使用头孢噻肟所导致的溶血性贫血极其罕见,而且其发生后的临床表现繁多,缺乏特异性,因此对于此类并发症的及时诊治尤为重要。本案例报道了一例关于头孢噻肟钠所导致的免疫性溶血性贫血,该患者无溶血、贫血等相关病史及家族病史,虽然合并有慢性支气管炎,但术前各项检查均不足以支持存在潜在的溶血可能,患者否认药物食物过敏史,且行抗菌药物皮试后提示阴性。患者于结肠癌术前和术后均使用了头孢噻肟钠进行术前准备及治疗,在用药后患者发生了一系列溶血相关症状,且经过停止使用抗生素、补液、输血等治疗后患者上述症状缓解,经与相关科室会诊后最终确立诊断。药物导致的免疫性溶血性贫血(DIIHA)发生率低,但并不意味着不会发生,作为一名临床医生,如果在使用抗生素后,患者突然出现本案所报道的类似临床症状时,在排除其他可能发生的疾病及并发症后,需要警惕DIIHA的发生,不仅为了挽救患者的生命,同时也要引以为鉴,防微杜渐。
Hemolytic anemia caused by Cefotaxime Sodium before colon cancer surgery is a rare complication.It is particularly important to timely diagnose and treat because of its complicated clinical symptoms.We reported one case of hemolytic anemia caused by Cefotaxime Sodium.The patient whose cefotaxime skin test was negative denied the medical history of hemolysis or hypohemia.And he had no allergic history which includes medicaments and alimental allergies.The pre-operative examination was not enough to support the possibility of the occurrence of hemolysis.After using the Cefotaxime Sodium,the patient developed a series of symptoms of hemolysis and recovered when we stopped the medication.We finally established the diagnosis with consultation of relevant departments.Drug-induced immune hemolytic anemia(DIIHA)is a rare complication,but does not mean that it will never happen.As a clinician,if patients have similar clinical symptoms reported in this case,we need to be alert to the occurrence of DIIHA.Not only to save the patients'life,but also to learn from it and to take precautions.
作者
郑一文
刘洪洲
ZHENG Yiwen;LIU Hongzhou(Department of Colorectal Surgery,Heping Hospital Affiliated to Changzhi Medical College,Shanxi Province,Changzhi046000,China)
出处
《中国当代医药》
CAS
2023年第10期179-181,共3页
China Modern Medicine
关键词
溶血性贫血
围手术期
预防性
头孢噻肟钠
结肠癌
Hemolytic anemia
Perioperative period
Prophylactic
Cefotaxime Sodium
Colon cancer
