手术中严重过敏反应患者的特点分析  

Analysis of clinical characteristic of patients with perioperative anaphylaxis

作　　者：汤蕊[1] 刁颖[1] 陈适[1] 孙劲旅[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院变态反应科,北京100730

出　　处：《实用临床医药杂志》2014年第16期53-55,59,共4页Journal of Clinical Medicine in Practice

摘　　要：目的分析手术引起的严重过敏反应患者的临床特点。方法回顾性分析1990年至今发生严重过敏反应将患者的临床特点。结果患者平均年龄39±16岁,男∶女=1∶2.2;发作时收缩压及舒张压均较基础血压明显下降(P<0.01),发作心率较基础心率明显增加(P<0.01);手术组发生严重过敏反应的患者与非手术组相比,女性患者更常见(P<0.01);2008年后手术组患者较非手术组患者有明显增加(P<0.01);手术组患者的基础疾病多为肿瘤(10/14),以妇产科手术居首(10/14),而非手术组患者的基础疾病多表现为变态反应性疾病(9/28);手术组患者病因最常见为抗生素(8/14),其次为麻醉剂(5/14),非手术组患者最常见病因同样为抗生素(6/28),其次为造影剂(4/28)和食物(4/28);手术组和非手术组患者发作血压均较基础血压明显下降(P<0.01),非手术组更易出现血压下降为0(9/12);严重过敏反应最常见的临床表现为皮肤黏膜症状,手术组患者更易出现意识丧失(P<0.01);手术组患者白细胞升高较非手术组更加明显(P<0.05);与手术组患者相比,非手术组患者更易危及生命(3/28)。结论严重过敏反应最常见的临床表现为皮肤黏膜症状。手术组发生严重过敏反应的患者与非手术组相比,女性患者更常见,基础疾病多为肿瘤,以妇产科手术居首,病因常为抗生素和麻醉剂,更易出现意识丧失,白细胞升高更加明显,2008年后有明显增加的趋势;非手术组患者的基础疾病多表现为变态反应性疾病,常见病因为抗生素、造影剂和食物,血压更易下降为0,易危及生命。Objective To analyze the clinical characteristics of patients with perioperative anaphylaxis,and compared with the non-operative patients. Methods We analyzed the condition,age characteristic,underlying diseases,operation,cause,change of blood pressure,clinical manifestation,level of white blood cell,and prognosis of patients with anaphylaxis from 1990 retrospectively.Results The mean age was 39 ± 16 years old. The ratio of Male and female was 1：2. 2. Dropping in systolic and diastolic blood pressure（P〈0. 01） and increase in heart rate（P〈0. 01） were notable.Compared with non-operative patients,among the perioperative patients female patients were more common（P〈0. 01）,the number of patients increased obviously after 2008,the majority underlying disease and operation were tumor（10 /14） and gynecology and obstetrics（10 /14）,the common cause was antibiotics（8 /14） and anesthetic（5 /14）,and the patients were prone to loss of consciousness（P〈0. 01）. However among the non-operative patients allergic diseases（9 /28） were the majority underlying disease,the common cause was antibiotics（6 /28）,contrast medium（4 /28） and food（4 /28）,blood pressure was prone to drop to 0（9 /12）,white blood cell increased obviously（P〈0. 05） and life-threatening was common（3 /28）. Conclusion Compared with non-operative patients,female patients were more common,the number of patients increased obviously after 2008,the majority underlying disease and operation were tumor and gynecology and obstetrics,the common cause was antibiotics and anesthetic,and the patients were prone to loss of consciousness among the perioperative patients.

关 键 词：严重过敏反应 手术 临床特点 

分 类 号：R781.6[医药卫生—口腔医学]