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1例46岁鼻咽癌女性患者曾接受放疗和化疗4年余。入院后给予紫杉醇加奥沙利铂化疗。化疗结束后第2天,为预防化疗后中性粒细胞减少症给予非格司亭200μg皮下注射。用药后约30min,患者突然出现头昏、呼吸困难、心慌、胸闷、恶心、呕吐及颤抖。查体:P87次/min,R28次/min,BP80/53mmHg,SPO20.94。立即给予吸氧,肌内注射苯海拉明,静脉推注地塞米松,肌内注射甲氧氯普胺,静脉滴注多巴胺。20min后再次查体:P73次/min,R23次/min,BP101/64mmHg,SPO20.99。1h后症状缓解。追问病史,患者4年前曾皮下注射非格司亭出现过敏性休克。
A 46-year-old woman with nasopharyngeal carcinoma received radiotherapy and chemotherapy more than 4 years. After admission to give paclitaxel plus oxaliplatin chemotherapy. On the second day after chemotherapy, subcutaneous injection of filgrastim 200 μg was given for preventing neutropenia after chemotherapy. About 30 minutes after treatment, the patient suddenly dizziness, difficulty breathing, palpitation, chest tightness, nausea, vomiting and trembling. Physical examination: P87 times / min, R28 times / min, BP80 / 53mmHg, SPO20.94. Immediately give oxygen, intramuscular injection of diphenhydramine, intravenous dexamethasone, intramuscular injection of metoclopramide, intravenous infusion of dopamine. 20min after the physical examination again: P73 times / min, R23 times / min, BP101 / 64mmHg, SPO20.99.1h after symptom? Asked history, patients with subcutaneous injections of filgrastim 4 years ago, anaphylactic shock.