心脏手术后抗感染治疗出现红人综合征的救治经验总结  

Treatment experience of red man syndrome in anti-infective therapy after cardiac surgery

作　　者：陈小芳[1] 徐航[2] 周庆[1] 潘俊[1] 王东进[1] CHEN Xiaofang;XU Hang;ZHOU Qing;PAN Jun;WANG Dongjin(Department of Cardiothoracic Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院心胸外科,南京210008 [2]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《药学服务与研究》2022年第1期62-65,共4页Pharmaceutical Care and Research

基　　金：南京大学医院管理研究所课题项目和南京鼓楼医院医学发展医疗救助基金会资助项目(NDYG2020037)。

摘　　要：目的:总结心脏手术后抗感染治疗导致红人综合征的救治经验。方法:回顾性收集南京大学医学院附属鼓楼医院2013年1月至2020年8月心脏手术后抗感染治疗出现红人综合征的病例资料,分析其临床特点及发生红人综合征的影响因素。结果:有6例患者在术后抗感染治疗中出现了严重的红人综合征,其中4例为应用万古霉素治疗过程中及治疗后出现红人综合征,1例使用替考拉宁23 d并停用5 d后出现,1例为应用头孢他啶治疗13 d后出现。6例患者经积极治疗后全部康复出院。结论:红人综合征在心脏手术后抗感染治疗过程中较为常见,多由万古霉素过敏引起。早期表现为局部出现红色皮疹、丘疹或斑丘疹,伴有瘙痒。如不积极治疗,皮疹可扩散至全身各部位,甚至出现休克症状,病情极为危重,早期高度重视并采取积极有效的抢救措施,可使患者转危为安。Objective:To summarize clinical experience of red man syndrome in anti-infective therapy after cardiac surgery.Methods:The data of red man syndrome in anti-infective therapy after cardiac surgery from January 2013 to August 2020 were retrospectively collected from Nanjing Drum Tower Hospital for study.Clinical characteristics and factors influencing the occurrence of red man syndrome were analyzed.Results:In anti-infecive therapy after cardiac surgery,there were totally 6 patients with red man syndrome,of whom 4 developed the syndrome during the treatment course of vancomycin or after application of the drug,one developed the syndrome induced by teicoplanin after using the drug for 23 days and 5 days after drug withdrawal,and one occurred following application of cephalosporins for 13 days.With effective treatment,all the 6 patients recovered and were discharged from hospital.Conclusion:Red man syndrome is quite common in the process of anti-infective therapy after cardiac surgery,which is mostly caused by vancomycin allergy.Early manifestations are local red rash,papule or maculopapular rash,with itching.If not actively treated,rash can spread to all parts of the body,or even cause shock with critical conditions.Early attention and active salvage measures could help patients to be out of danger.

关 键 词：红人综合征 药物副反应报告系统 万古霉素 心脏手术 

分 类 号：R994.11[医药卫生—毒理学] R978.1[医药卫生—药学]