创伤性休克患者破伤风抗毒素皮内试验的临床研究  

Condition control and result determination of tetanus antitoxin intracutaneous test in traumatic shock patients

作　　者：徐桂琴[1] 何忠杰[1] 马俊勋[1] 

机构地区：[1]解放军总医院304临床部急救部,北京100037

出　　处：《感染．炎症．修复》2005年第2期103-105,共3页Infection Inflammation Repair

摘　　要：目的：探讨破伤风抗毒素(TAT)皮试液注射浓度与试验阳性结果的关系,探讨对严重创伤性休克患者进行破伤风抗毒素皮内试验的临床意义,为进一步规范破伤风抗毒素的临床应用提供一条思路。方法：采取皮内试验与脱敏治疗同时进行的方法,对164例TAT不同浓度皮内试验结果进行比较。观察480例创伤性休克患者破伤风抗毒素皮内试验的结果,并与同期就诊的480名轻伤员的破伤风抗毒素皮内试验进行一次脱敏注射。结果：164例TAT试验无一例全身反应发生。创伤性休克患者破伤风抗毒素皮内试验阴性率98%,显著高于对照组。结论：创伤情况下需要注射TAT者,不管TAT皮试是阴性还是阳性,都将注射TAT。皮内试验与脱敏治疗同时进行,减少了假阳性的出现,避免了因假阳性而进行脱敏治疗给伤员造成的痛苦,也减轻了护士的工作量。急救时对创伤性休克患者进行过敏试验结果判断需要慎重。Objective:To investigate the result of tetanus antitoxin intracutaneous test in traumatic shock pa- tients.Methods:The results of tetanus antitoxin tests were observed in 480 patients with traumatic shock,and they were compared with the result of the same in patients with minor trauma without shock.Results:Intracutane- ous tetanus antitoxin test was negative in 98% of patients with traumatic shock,and it was significantly higher than that of the patients without shock(P＜0.01).Conclusions:During emergency care,the result of tetanus an- titoxin intracutaneous test for allergic reaction is not reliable in patients with traumatic shock,therefore a negative test should not preclude desensitization measure in administration of the antiserum.

关 键 词：创伤性休克 破伤风抗毒素皮内试验 应激反应 免疫抑制 

分 类 号：R64[医药卫生—外科学]