头孢菌素类抗生素过敏性休克225例分析及其用药监护

目的 了解头孢菌素类抗生素(头孢类)过敏性休克的发生和预后，为临床合理用药提供参考。方法 对国内1990年1月至2003年6月193篇有关头孢类过敏性休克病倒报道的225例进行分析整理。结果 225例休克涉及12种药物，居前6位的是头孢噻肟、头孢唑啉、头孢氨苄、头孢哌酮、头孢曲松、头孢拉定，占94．2％。过敏史阳性者24．0％，无过敏史者30．2％，过敏史不清者45．8％。85．8%的休克发生于用药20min内，死亡率8．0％。结论 头孢类过敏性休克应引起医护人员高度重视，用药前仔细询问过敏史，对过敏史阳性者做皮试是防止严重过敏事件发生的最重要措施。

Analysis of 225 Cases of Allergic Shock Induced by Cephalosporins and Monitoring of Medicine

Objective To investigate the regularity of the allergic shock induced by cephalosporins. Methods Two hundred and twenty-five cases of allergic shock induced by cephalosporins were analyzed through Chinese literature retrieval from 1990-2003. Results The 225 cases of allergic shock involved 12 cephalosporins, and 94.2% of them were caused by 6 cephalosporins, namely, cefotaxime, cefazolin, cephalexin, cefoperazone, ceftriaxone and cefradine. 24.0% of the patients had the allergic history, 30.2% had no allergic history and 45.8% had unclear allergic history. Allergic shock occurred in 20 min after cephalosporins in 85.8% of the cases. The mortality rate was about 8.0%. Conclusion Attention should be paid to the cephalosporin-induced allergic shock. It is indispensable to inquire about the allergic history and take the dermal sensitivity test before administration for the patients with allergic history.