注射用甘氨双唑钠致过敏性休克1例

1例50岁男性患者,因甲状腺恶性肿瘤伴肺转移行"胸腔镜左肺下叶部分切除、胸腔粘连烙断术"和"甲状腺左叶癌根治术、右叶全切除术、中央组淋巴结清扫术、左侧颈部淋巴结清扫术、双侧喉返神经探查术",此次为肿瘤术后同位素治疗再次入院。入院第3日,给予注射用甘氨双唑钠1.25 g,qd,ivgtt。输至约5 min时患者突然出现大汗、面部苍白、四肢无力、摔倒、意识丧失数秒钟,意识恢复后仍大汗,面色苍白,立即停止静脉滴注注射用甘氨双唑钠,更换输液器,补液对症支持治疗。测P 90·min^-1,BP 120/70 mm Hg。约5 min后,患者可在搀扶下缓慢活动,约20 min后上述症状较前好转,但出现全身瘙痒,背部可见红色斑丘疹,压之退色。给予静脉滴注0.9%氯化钠注射液250 mL、1 g葡萄糖酸钙注射液,及口服氯雷他定片10 mg,1 h后,患者瘙痒症状缓解,皮疹消退,无不适,血压、心率平稳。后续治疗中患者未再出现大汗、面部苍白、四肢无力、意识丧失、皮疹、瘙痒等症状,3 d后,患者病情平稳,予以出院。

One case of allergic shock induced by glycididazole sodium for injection

A 50-year-old male patient with thyroid malignancy and pulmonary metastasis was admitted into hospital for postoperative isotope therapy,thoracoscopic partial resection of the left lower lobe of the lung,thoracoscopic adhesion cauterization and radical resection of the left lobe of thyroid cancer,total resection of the right lobe,central group lymph node dissection,left neck lymph node dissection,bilateral recurrent laryngeal nerve exploration were performed for thyroid cancer with lung metastasis.Glycididazole sodium for injection(1.25 g,qd,ivgtt)was given to him at the 3 rd day after admission.Five minutes later,the patient developed sweating,face pale,limbs weakness,falling down and unconsciousness for several seconds.Sweating and face pale continued after consciousness recovery.Glycididazole sodium for injection was stopped immediately.The syringe was changed and fluid replacement was given to him.His vital signs were as follows:P 90 beats·min^-1,BP 120/70 mm Hg.After 20 minutes,the above symptoms were improved,but there were pruritus all over the body and red papules on the back.And then,calcium gluconate injection(1 g,ivgtt)combined with 0.9% sodium chloride injection(250 mL,ivgtt),loratadine tablets(10 mg,po)were given to him.One hour later,the pruritus and papules relieved.His heart rate and blood pressure were stable.Thereafter his condition kept stable and he was discharged 3 days later.