左氧氟沙星氯化钠致以短暂意识丧失为临床表现的速发型药物超敏反应1例  

A case of immediate drug hypersensitivity reaction with transient loss of consciousness as clinical manifestation caused by levofloxacin

作　　者：郑造乾[1] 骆瑾瑜[2] 余荣亮 Zheng Zao-qian;Luo Jin-yu;Yu Rong-liang(Doctor-patient Relations Office,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Nursing Department,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院医患关系办公室,杭州310012 [2]浙江省立同德医院护理部,杭州310012

出　　处：《中国药物应用与监测》2024年第1期90-93,共4页Chinese Journal of Drug Application and Monitoring

基　　金：浙江省医药卫生科技计划项目(2023KY081)。

摘　　要：1例53岁男性患者,因上呼吸道感染于2022年12月23日给予盐酸氨溴索注射液化痰+左氧氟沙星氯化钠注射液(0.5 g:100 mL,即刻,静脉滴注)抗感染治疗。在静脉滴注左氧氟沙星氯化钠注射液约17 min(约25 mL)时,患者出现胸闷心慌,呼吸急促,皮肤瘙痒,随后出现短暂意识丧失,呼之不应,小便失禁,以及全身皮疹、皮肤潮红、肿胀等皮肤反应。立即停止输液并更换输液器,予急诊内科护理常规,特级护理,心电监护,2 L·min^(-1)吸氧、卧床休息、开通静脉通路等处理,肌内注射盐酸异丙嗪注射液25mg,并送入抢救室,途中患者意识恢复,持续3min左右。经过治疗后明显好转。经诺氏评估量表评分为7分,考虑为左氧氟沙星氯化钠注射液所致的以短暂意识丧失为临床表现的速发型药物超敏反应。A 53-year-old male patient was treated with ambroxol hydrochloride injection(30 mg:100 mL,st,ivgtt)and levofloxacin sodium chloride injection(0.5 g:100 mL,st,ivgtt)due to upper respiratory tract infection on December 23,2022.After intravenous infusion of levofloxacin sodium chloride injection for about 17 minutes(about 25 mL),the patient developed to chest tightness and palpitations,shortness of breath,skin itching,and then transient loss of consciousness(TLOC)and no response to a verbal command,urinary incontinence,as well as skin reactions such as rash,skin redness,and swelling.The infusion was-1 immediately stopped,the infusion device was replaced,the routine and special care,electrocardiogram monitoring,2 L·min oxygen inhalation,bedridden rest and opening of venous access were carried out by the emergency internal medicine department,the case was given intramuscular injection of 25 mg of promethazine hydrochloride injectionand was transported to the emergency room.During the process,the patient regained consciousness and lasted for 3 minutes.and the condition was remarkably improved after oxygen inhalation,use of antihistamines,corticosteroids,intravenous infusion.The case scored 7 points by the Naranjo's evaluation scale,taking into account the immediate drug hypersensitivity reaction(IDHR)caused by levofloxacin sodium chloride injection,with TLOC as the clinical manifestation.

关 键 词：速发型药物超敏反应 左氧氟沙星 短暂意识丧失 小便失禁 

分 类 号：R969.3[医药卫生—药理学]