摘要
患者男,27岁,2017年10月3日因热液烫伤躯干、臀部及四肢等多处6h后收入笔者单位,烧伤总面积约60%体表总面积,深度为深Ⅱ~Ⅲ度。入院后立即给予抗休克、补液及抗感染等对症支持治疗,行2次清创植异种(猪)皮手术后,创面愈合良好。入院第12天根据血微生物培养及药物敏感试验结果使用利奈唑胺抗感染,患者血乳酸水平持续升高,8d后停用利奈唑胺,口服维生素B11周后,乳酸水平逐渐降至正常。该病例主要分析利奈唑胺是否直接导致高乳酸血症及其重要机制,目的在于提示临床医师在使用利奈唑胺时应警惕高乳酸血症的风险,如出现此风险,应立即停用利奈唑胺并口服维生素B1纠正高乳酸值,必要时调整治疗计划。
On October 3rd, 2017, one male patient, aged 27 years, was admitted to our hospital 6 hours after hydrothermal scald of torso, buttocks, and limbs. The total area of burn was about 60% total body surface area, and the depth was from deep partial-thickness burn to full-thickness burn. Immediately after admission, the patient was given symptomatic support treatments, such as anti-shock, fluid replacement, and anti-infection, etc. After being treated by debridement and xenogenic (porcine) skin grafting for 2 times, the wounds were healed well. On the 12th day of admission, linezolid was used to prevent infection according to the results of microbial culture and drug sensitivity test, since when the level of his blood lactate continued to increase. After 8 days, linezolid was discontinued and vitamin B1 was given orally for 1 week, and the level of lactic acid gradually decreased to normal in result. This case was used mainly to analyze whether linezolid could directly cause hyperlacticemia and its important mechanism, aiming at reminding clinicians of being alert to the risk of hyperlacticemia when using linezolid. If hyperlacticemia occurs, linezolid should be discontinued immediately and vitamin B1 should be taken orally to correct the high lactic acid value, and the treatment plan should be adjusted if necessary.
作者
肖妍
王鹏
李如兵
田俊英
付忠华
毛远桂
张红艳
Xiao Yan;Wang Peng;Li Rubing;Tian Junying;Fu Zhonghua;Mao Yuangui;Zhang Hongyan(Department of Burns, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2019年第8期614-616,共3页
Chinese Journal of Burns
