围术期快速静滴万古霉素致全麻患者严重过敏性休克1例  

A case of severe anaphylactic shock caused by rapid perioperative infusion of Vancomycin in general anesthesia

作　　者：陈凤 CHEN Feng(Department of Anesthediology,Fuqing Hospital Affiliated to Fujian Medical University,Fujian Province,Fuqing350300,China)

机构地区：[1]福建医科大学附属福清市医院麻醉科,福建福清350300

出　　处：《中国当代医药》2021年第19期144-147,共4页China Modern Medicine

摘　　要：围术期严重过敏反应多是突发和不可预测的,病情变化迅速,常常累及心血管系统。围术期因为循环容量不足、麻醉诱导、各种类型休克等病因而出现的血压下降、心率增快、血氧饱和度下降。因此如何快速有效进行鉴别诊断和治疗至关重要。本文分享1例全麻诱导插管后快速滴注万古霉素导致严重过敏性休克病例的抢救和复苏成功后继续手术过程中的处理。从围术期全麻后过敏性休克的监测重点、优化复苏成功后继续手术的麻醉管理和预防性使用抗生素三个方面来学习《围术期过敏反应诊治的专家共识》中的诊断和治疗流程。Severe allergic reactions during the perioperative period are mostly sudden and unpredictable,the condition changes rapidly,and the cardiovascular system is often involved.During the perioperative period,blood pressure,heart rate increased,and blood oxygen saturation decreased due to insufficient circulation volume,induction of anesthesia,and various types of shock.Therefore,how to perform differential diagnosis and treatment quickly and effectively is very important.This article shares a case of severe anaphylactic shock caused by rapid infusion of Vancomycin after general anesthsia induction and intubation,and the treatment of continued operation after successful resuscitation.Learn the diagnosis and treatment process of the Expert Consensus on Diagnosis and Tredtment of Perioperative Allergic Reactions from three aspects:the monitoring focus of anaphylactic shock after perioperative general anesthesia,optimization of anesthesia management for continued operation after successful resuscitation,and preventive use of antibiotics.

关 键 词：快速滴注万古霉素 围术期过敏性休克 预防性抗生素合理用药 麻醉管理 

分 类 号：R619[医药卫生—外科学]