Phelps K R, Naylor K, Brien T P, Wilbur H, Haqqie S S
Medical, Laboratory Medicine, and Surgical Services, Stratton Department of Veterans' Affairs Medical Center, and Albany Medical College, New York 12208, USA.
Am J Med Sci. 1999 Sep;318(3):181-5. doi: 10.1097/00000441-199909000-00013.
A 70-year-old man with advanced obstructive nephropathy began to hemorrhage from the bladder after decompression with a Foley catheter. Manifestations of encephalopathy appeared after continuous irrigation with 1% alum for 2 days and were associated with elevated serum aluminum concentrations. Repeated treatments with deferoxamine and hemodialysis accomplished some aluminum removal, but the patient succumbed to bronchopneumonia. Brain aluminum content was not excessive at autopsy. A literature review suggests that intact renal function is essential to rapid disposal of a parenteral aluminum load and indicates that most reported instances of encephalopathy after alum irrigation have occurred in patients with compromised renal function. We conclude that alum should not be employed as a bladder irrigant in patients with acute or chronic renal failure.
一名患有晚期梗阻性肾病的70岁男性在使用Foley导尿管减压后开始出现膀胱出血。在用1%明矾持续冲洗2天后出现脑病表现，并与血清铝浓度升高有关。用去铁胺反复治疗和血液透析去除了一些铝，但患者死于支气管肺炎。尸检时脑铝含量并不高。文献综述表明，完整的肾功能对于快速清除肠外铝负荷至关重要，并且表明大多数报道的明矾冲洗后脑病病例发生在肾功能受损的患者中。我们得出结论，急性或慢性肾衰竭患者不应使用明矾作为膀胱冲洗剂。
