过敏反应

一位60岁的老人想要谈谈他最近被昆虫叮咬后的过敏反应，他出示了一封急诊室的信，上面写着：“被蜜蜂叮咬后的过敏反应，治疗之后要找全科医师随访。”应该考虑哪些问题 发生了,什么事？这是否是过敏反应？过敏反应这个词可能涉及急性的、潜在致命的系统过敏性功能紊乱，包括心血管系统和呼吸系统，或者两者皆有。     

Anaphylaxis: diagnosis and management

Anaphylaxis is a serious, rapid-onset, allergic reaction that may cause death. Severe anaphylaxis is characterised by life-threatening upper airway obstruction, bronchospasm and/or hypotension. Anaphylaxis in children is most often caused by food. Bronchospasm is a common symptom, and there is usually a background of atopy and asthma. Venom- and drug-induced anaphylaxis are more common in adults, in whom hypotension is more likely to occur. Diagnosis can be difficult, with skin features being absent in up to 20% of people. Anaphylaxis must be considered as a differential diagnosis for any acute-onset respiratory distress, bronchospasm, hypotension or cardiac arrest. The cornerstones of initial management are putting the patient in the supine position, administering intramuscular adrenaline into the lateral thigh, resuscitation with intravenous fluid, support of the airway and ventilation, and giving supplementary oxygen. If the response to initial management is inadequate, intravenous infusion of adrenaline should be commenced. Use of vasopressors should be considered if hypotension persists. The patient should be observed for at least 4 hours after symptom resolution and referred to an allergist to assist with diagnosis, allergen avoidance measures, risk assessment, preparation of an action plan and education on the use of self-injectable adrenaline. Provision of a MedicAlert bracelet should also be arranged.     

血浆代用品过敏反应的观察

目的:防治血浆代用品在临床应用过程中所出现的过敏反应.方法:临床观察的血浆代用品主要是贺斯和聚明胶肤这两种注射液,使用贺斯3212瓶、聚明胶肤2566瓶,观察过敏反应的例数和临床表现.结果:贺斯出现过敏反应18例,占使用总数0.560%;聚明胶肽出现过敏反应26例,占使用总数1.017%.结论:从过敏反应的发生率、发生机制、临床表现、诊断、预防、治疗等方面阐述了合理使用血浆代用品的经验.     

Anaphylaxis due to thiopental sodium anesthesia.

Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions to infused thiopental have appeared, generally in the anesthesiology literature. Documentation of the immunologic responses to thiopental sodium has been limited to the demonstration of an allergic reaction to thiopental by skin testing in some cases. This report describes a woman who, after having tolerated thiopental sodium and other general anesthetics, became sensitive to this agent and had a severe acute reaction at the time of induction of general anesthesia.