低分子右旋糖酐氨基酸注射液致过敏性休克1例

1病例报告 患者，男，46岁，面颈躯干四肢中度烧伤入院治疗，2003年10月8日给予低分子右旋糖酐氨基酸注射液（长海长征富民药业公司，批号030623）250ml，vd．，在缓慢滴入5ml后，病人突然出现全身麻木，畏寒，     

低分子右旋糖酐过敏性休克抢救1例

1 临床资料 患者，女，58岁。因左侧肢体无力1＋天入院。头颅CT示双侧基底节腔隙性脑梗塞。予以保护脑细胞，降颅压，抗血栓治疗。既往无药物过敏史，未使用过低分子右旋糖酐，当输用低分子右旋糖旋酐液体约10ml，病人突然心悸，胸闷，咽喉紧缩感，呼吸困难，恶心欲呕，双眼黑朦，二便自遗。查体：BP60／40mmHg，P124次／分。诊断为低分子右旋糖酐所致的过敏性休克。[第一段]     

低分子右旋糖酐静脉滴注引起过敏性休克1例报告

1 病例 患者女性，32岁。因“眩晕、呕吐一天”入院，诊断为“内耳性眩晕”。入院后按医嘱静脉滴注低分子右旋糖酐500ml，每分钟30滴，10分钟后，患者感觉胸闷、心悸、呼吸困难、皮肤搔瘁，并出现风团样荨麻疹，眼睑水肿，结膜充血，面色苍白，出冷汗，烦躁不安，脉搏微弱。查体：T35．8℃，P122次／分，R28次／分，Bp60／48mmHg，双肺呼吸音粗，未闻罗音，心率122次／分，律整。心音低钝，未闻病理性杂音，四肢皮肤湿冷。     

麻醉期间低分子右旋糖酐氨基酸注射液致重度过敏性休克1例

1病例报告李某,女,45岁,2009年5月12日因子宫肌瘤于我院行子宫肌瘤剔除术。询问病史既往无心血管疾病史与肺部疾病史,无药物过敏或食物过敏史。入院查体：体温36.7℃,脉搏80次/min,呼吸20次/min,血压118/80mmHg,双肺呼吸音清,无干湿性啰音,心音可,律齐,各瓣膜听诊区未闻及杂音。     

低分子右旋糖酐致过敏性休克的临床研究

目的了解低分子右旋糖酐引起过敏性休克的情况.方法检索近10年全国医药学期刊有关文献.结果低分子右旋糖酐引起过敏性休克59例中男性高于女性,高龄大于低龄,其发生反应时间大多数在静滴期间30 min内.结论护士对低分子右旋糖酐引起的过敏性休克应引起足够重视.     

低分子右旋糖酐致过敏性休克1例抢救成功的护理体会

低分子右旋糖酐注射液是临床常用的降低血液黏滞性、改善微循环、扩充血容量药物：该药的过敏反应比较少见，临床表现为皮肤红晕、瘙痒、发热、恶心、呕吐、视物模糊、关节痛、出血等。极个别人有血压下降、呼吸闲难，致过敏性休克。本文将我科2007年2月收治1例低分子右旋糖酐注射液致过敏性休克，昏迷90min，通过医护人员的积极抢救和精心护理，挽救了患者生命，且末留下任何后遗症，痊愈出院，现报告如下。     

低分子右旋糖酐合并川芎嗪静滴致过敏性休克1例

1临床资料 患者男,64岁,因左基底节区脑内血肿收入我科,既往无过敏史,入院后行对症处理.两日后患者复查CT示:左基底节区脑内血肿出血量增多,即在全麻下行左颞部钻孔左基底节区脑内血肿清除术.术后患者体检:神志清楚,右侧中枢性面瘫,左侧肢体肌力Ⅳ级,右侧肢体肌力Ⅱ级,各项生命体征正常,病情渐趋稳定,接受康复治疗.     

低分子右旋糖酐致过敏性休克的临床研究

目的 了解低分子右旋糖酐引起过敏性休克的情况。方法 检索近10年全国医药学期刊有关文献。结果 低分子右旋糖酐引起过敏性休克59例中男性高于女性，高龄大于低龄，其发生反应时闽大多数在静滴期间30min内。结论 护士对低分子右旋糖酐引起的过敏性休克应引起足够重视。     

低分子右旋糖酐致过敏性休克的抢救护理

低分子右旋糖酐 (以下简称低右 )可引起“类过敏或过敏反应” (DIAR) ,发生率为 0 0 3%～ 4 7% ,严重DIAR可达 0 0 0 8%～ 0 6 %。我院自 2 0 0 1年 3月至 2 0 0 3年 5月共发生 8例因静脉滴注低右致过敏患者 ,其中 2例患者起病急骤 ,临床表现典型 ,但因发现早、诊断及时、抢救护理迅速 ,患者很快脱离危险。现报告如下。一、临床资料例 1,女性 ,2 8岁 ,怀孕 30周 ,产前检查发现羊水过少 ,医嘱给低右5 0 0ml静脉滴注 ,每天一次。患者首次在门诊输液室输入低右约 4 0 0ml时 ,突然出现胸闷、呼吸急促、面色苍白 ,继之出现神志不清、口唇…     

低分子右旋糖酐液致过敏性休克1例

我院2003年收治1例因车祸致蛛网膜下腔出血、寰椎前方双侧线形骨折伴枢椎脱位患者，给予低分子右旋糖酐静滴，致使患者出现过敏性休克。现总结报告如下。     

静滴低分子右旋糖酐致过敏性休克一例

低分子右旋糖酐是一种常用的血容量扩充剂,在临床使用中.偶有发热、荨麻疹等过敏反应,一般不严重,停药给予抗过敏的药物即可.但个别敏感患者可出现严重的全身反应,甚至过敏性休克,若不及时抢救,可在短期内危及生命.     

The role of low molecular weight dextran on platelet pulmonary trapping during endotoxin-induced shock

In vivo behaviour of Indium-111-labelled platelets were followed simultaneously in the lungs, liver, spleen and kidneys in 16 adult sheep which were exposed to intravenous injection of endotoxin (10 micrograms/kg body wt.). The effects on the respiratory function and the central hemodynamics were also followed. Eight sheep received, 30 min after the endotoxin challenge, continuous intravenous infusion of low molecular weight dextran during 4 h while the other eight animals served as controls. A marked pulmonary and hepatic platelet sequestration was observed during and just after the endotoxin infusion and was followed by a marked platelet disaggregation within 30 min in both the groups. Three hours after the endotoxin a second wave of platelet sequestration occurred in the control animals, both in the lungs and in the liver, but no such increase was seen in the low molecular weight dextran-treated group. Within the kidneys only minor changes occurred during the experiment period. In the spleen, however, there was a decrease in platelet sequestration after endotoxin in both groups. Less marked hemodynamic and respiratory alterations occurred in the dextran-treated group compared to the controls. It was concluded that low molecular weight dextran decreases sequestration of platelets in the lungs and in the liver of sheep during endotoxic shock.     

氨曲南致过敏性休克1例

患者,女,20岁。因＂咳嗽、咳痰5 d＂来急诊。既往有青霉素和头孢菌素类过敏史。体检：体温38.3℃,心率87次/min,呼吸16次/min,血压120/80mmHg（1mmHg=0.133kPa）,咽部充血,双肺呼吸音粗,可闻及湿啰音,心腹查体无明显异常,胸片示双肺中内带纹理增强紊乱,以右下肺明显。     

右旋糖酐铁注射液引起严重变态反应1例

右旋糖酐铁是临床上常用的静脉补铁药物,在首次应用该药物时应按要求和方法做过敏试验.我科于2008年12月收治1例肾病综合征病人,在应用右旋糖酐铁剂试验剂量输入结果阴性后,给予静脉输注,每周1次.于第4周输入该药液后发生严重变态反应,现报告如下.     

The effect of low molecular weight dextran on haemodynamics and respiratory function during endotoxin-induced shock.

The effects of low molecular weight dextran (LMWD) infusion, on gas exchange and haemodynamics were evaluated in sheep during endotoxin shock. The infusion of LMWD was started after signs of shock and lung injury were evident. After a stabilization period 10 micrograms kg-1 E. Coli endotoxin was infused i.v.. Endotoxin infusion resulted in an marked increase in pulmonary artery pressure (PAP) and decrease in mean arterial pressure (MAP), respiratory compliance, arterial oxygen tension (PaO2) and oxygen delivery index (DO2l). After 3 h MAP, PaO2, DO2l and compliance improved significantly in LMWD treated animals. The PAP had also decreased significantly in the LMWD-treated animals, but remained high in the controls (P less than 0.01). It was concluded that LMWD infusion improves haemodynamics and gas-exchange in sheep during endotoxin shock.     

1例硫普罗宁致过敏性休克病人的抢救及护理

硫普罗宁 (tiopronin ,商品名凯西莱 )为一种含游离巯基的甘氨酸衍生物 ,它参与肝细胞代谢 ,维持肝细胞内谷胱甘肽浓度 ,改善肝细胞结构和功能 ,从而抑制肝细胞线粒体过氧化脂质的形成 ,保护肝细胞膜 ,增强机体免疫功能。我科从 1999年使用该药物至今首次出现 1例药物过敏性休克 (druganaphy lacticshock ,DAS) ,经积极救治 ,病人转危为安。1　病例简介　　病人 ,男 ,46岁 ,以发热原因待查收治入院 ,查肝功能异常 ,给予保肝药物硫普罗宁 0 .2 g加入 10 %葡萄糖 2 5 0mL中 ,以 60 gtt/min的速度首次静脉输注。 3min后 ,病人出现烦躁不安 ,…     

Low molecular weight dextran attenuates increase in extravascular lung water caused by ARDS

We studied the effect of low molecular weight dextran (mean molecular weight 40,000, Dextran 40; LMD) on the accumulation of extravascular lung water (EVLW), and also on hemodynamics and blood gases, in the oleic acid (OA)-injured lung in pentobarbital anesthetized rats. Starting just before the OA injection (0.01 mL/kg via femoral vein), 10% LMD in lactated Ringer's solution was infused throughout the experiment (5 mL/kg/h) instead of lactated Ringer's solution. OA caused acute lung injury leading to decreased oxygenation (PaO2: 87 +/- 11 mmHg versus control group 128 +/- 11) and an increased permeability of the alveolar-capillary membrane, as shown by increases in EVLW (4.89 +/- 0.54 versus control group 4.07 +/- 0.14), and albumin leakage (0.043 +/- 0.015 versus control group 0.010 +/- 0.004). LMD protected against the increase in EVLW (4.14 +/- 0.10) and the hypoxemia (112 +/- 19 mmHg), but it did not reduce the albumin leakage into the alveolar space (0.052 +/- 0.009). These data suggest that LMD may limit the fluid accumulation that is secondary to OA-induced lung injury.     

黍子垫在预防压疮中的应用

脑活素为脑神经营养药,临床上常用于颅脑外伤、脑血管病及脑炎病人的辅助治疗。我科自2003年6月—2005年10月使用脑蛋白水解物注射液治疗脑外伤综合征、脑血管病及脑炎致脑功能不全300例,其中1例发生过敏性休克,经及时抢救,脱离危险。现报道如下。1病例介绍病人,男,25岁,因头外     

黍子垫在预防压疮中的应用

压疮一直是护理工作中较为棘手的问题，也是临床上常见的并发症之一。骨科病人多数需绝对卧床休息治疗，很容易发生压疮，一旦发生压疮，不仅给病人带来痛苦，而且影响治疗效果，易发生感染，严重者会导致死亡。因此，预防压疮尤为重要。目前国内许多生产厂家制作了预防压疮的气垫床、水垫床、海绵床等，但由于透气性差，价格昂贵及应用繁琐等缺点，很难广泛用于临床。我科于2003年4月-2005年6月采用自制黍子（未脱壳的黄米）褥垫预防压疮，取得满意疗效。现将方法介绍如下。