中国药物警戒 ›› 2023, Vol. 20 ›› Issue (6): 709-711.
DOI: 10.19803/j.1672-8629.20220225

• 安全与合理用药 • 上一篇    下一篇

复方聚乙二醇电解质散(Ⅱ)致低钠性脑病1例分析

谢安劼, 王长德*, 陈卉, 张士强   

  1. 上海中医药大学附属上海市中西医结合医院神经内科,上海200082
  • 收稿日期:2022-05-06 出版日期:2023-06-15 发布日期:2023-06-15
  • 通讯作者: * 王长德,男,博士,主任医师,中医脑病。E-mail:wangch_de@163.com
  • 作者简介:谢安劼,女,硕士,主治医师,中西医结合临床。
  • 基金资助:
    上海市中医诊疗模式创新试点建设项目[ZY(2018-2020)-FWTX-6013]; 上海市虹口区“国医强优”三年行动计划(HGY-YSZK-2018-10)

One case of hyponatremia encephalopathy caused by compound polyethylene glycol electrolyte powder (Ⅱ)

XIE Anjie, WANG Changde*, CHEN Hui, ZHANG Shiqiang   

  1. Department of Neurology, Shanghai Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
  • Received:2022-05-06 Online:2023-06-15 Published:2023-06-15

摘要: 目的 以病例为基础探讨复方聚乙二醇电解质散(Ⅱ)致低钠血症的临床特点及诊治方案。方法 对1例复方聚乙二醇电解质散(Ⅱ)致低钠血症的病例进行分析讨论,并对相关文献报道进行归纳和总结。结果 1例62岁女性患者因“结肠息肉”住院行结肠镜检查,共服用复方聚乙二醇电解质散(Ⅱ)4袋(每袋68.56 g)溶入4 000 mL温水,用药后18 h患者出现意识不清,右下肢抽搐,小便失禁,急查血钠114 mmol·L-1,头颅CT平扫提示全脑水肿,诊断为低钠性脑病。经过对症治疗5 h后,患者自主睁眼,无对答。第3天,患者意识清楚,血电解质恢复正常,未再有肢体抽搐发作。结论 服用复方聚乙二醇电解质散(Ⅱ)进行肠道准备过程中需关注患者的临床症状及血电解质变化,尽量避免其可能导致的电解质紊乱而引发低钠性脑病,一旦发生不良反应应立即采取相应的治疗手段,同时应警惕出现其他并发症的风险。

关键词: 复方聚乙二醇电解质散(Ⅱ), 低钠性脑病, 癫痫, 电解质, 低钠, 低钾, 药品不良反应

Abstract: Objective To explore the clinical characteristics, diagnosis and treatment of hyponatremia caused by compound polyethylene glycol electrolyte powder (Ⅱ) . Methods One case of hyponatremia caused by compound polyethylene glycol electrolyte powder (Ⅱ) was analyzed, and the related literature was summarized. Results A 62-year-old lady was hospitalized for colonoscopy due to “colonic polyps”. She drank 4 bags (68.56 g/bag) of compound polyethylene glycol electrolyte powder (Ⅱ) dissolved in 4 000 mL of warm water. Eighteen hours after treatment, the patient lost consciousness and developed convulsion of the right lower limb and urinary incontinence. Quick examination showed that blood sodium was 114 mmol·L-1. Plain CT scan of the head revealed global brain edema so that the patient was diagnosed with hyponatremia encephalopathy. After 5 hours of symptomatic treatment, the patient opened her eyes without speaking. On the third day, the patient regained consciousness, blood electrolytes returned to normal, and there were no more limb convulsions. Conclusion After polyethylene glycol powder is prescribed, clinicians should pay attention to the changes of electrolytes and other clinical complications.

Key words: polyethylene glycol electrolyte powder (Ⅱ), hyponatremia encephalopathy, epilepsy, electrolyte, low sodium, low potassium, adverse drug reaction

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