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患者女,53岁,因咽癌发热来我院就诊,诊断为上呼吸道感染,给予头孢唑林钠注射液等静滴治疗,当0.9％氯化钠注射液100ml+头孢唑林纳3.0g输入几秒钟时,患者即出现双手、双脚针刺样感觉,胸闷眼前发黑,继之意识丧失,血压为70/40mmHg(9.3/5.3kPa),躯干及双上肢可见大片红色斑疹,压之褪色,指甲紫绀。诊断:过敏性休克,立即抢救。吸氧,吸痰,心电监护。同时依次静脉滴注5％葡萄糖注射液(5%GS)250ml+多巴胺100mg;10％GS250ml+多巴胺100mg+肾上腺素5mg;5％GS250ml+多巴胺80mG;琥珀酸氢化考的松 100mg+0.9％氯化钠注射液(NS)20ml;琥珀酸氢化考的松100mg+NS20ml。另开通道补液:静脉滴注平衡液500ml、5％GS250ml。约半小时后,患者意识逐渐恢复,为进一步治疗,转入急诊重症监护病房。继续予以激素、抗炎对症治疗等处理,患者病情好转。1周后痊愈出院。患者无青霉素等药物过敏史,无遗传性疾病史。
Female patient, 53 years old, because of pharyngogenic fever to our hospital, diagnosed as upper respiratory tract infection, given cefazolin sodium injection and other intravenous treatment, when 0.9% sodium chloride injection 100ml + Cefazolin Lin 3.0g enter a few Seconds, the patient showed both hands, feet acupuncture feeling, chest tightness eyes black, followed by loss of consciousness, blood pressure was 70 / 40mmHg (9.3 / 5.3kPa), trunk and upper extremity visible large red rash, pressure Fading, nails cyanosis. Diagnosis: Anaphylactic shock, immediate rescue. Oxygen, suction, ECG monitoring. While intravenous infusion of 5% glucose injection (5% GS) 250ml + dopamine 100mg; 10% GS250ml + dopamine 100mg + epinephrine 5mg; 5% GS250ml + dopamine 80mG; hydrocortisone succinate 100mg + 0.9% sodium chloride injection NS) 20ml; hydrocortisone succinate 100mg + NS20ml. Another open channel rehydration: 500ml intravenous infusion of balanced solution, 5% GS250ml. About half an hour later, patient awareness gradually restored, for further treatment, transferred to the emergency ICU. Continue to hormone, anti-inflammatory symptomatic treatment and other treatment, patients improved. A week after he was discharged. Patients without penicillin and other drug allergy history, no history of genetic disease.