多次静脉输液后出现严重过敏反应诊治一例  

A case of severe allergic reaction following multiple intravenous infusion

作　　者：许凤[1,2] 张莉[1,2] 张虹婷[1,2] 石楚琪 贾巧茹 肖浩[1,2] 孟娟[1,2] XU Feng;ZHANG Li;ZHANG Hongting;SHI Chuqi;JIA Qiaoru;XIAO Hao;MENG Juan(Allergy Center,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Otolaryngology,Head and Neck Surgery,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院变态反应中心,四川成都610041 [2]四川大学华西医院耳鼻咽喉头颈外科,四川成都610041

出　　处：《新医学》2024年第10期848-852,共5页Journal of New Medicine

基　　金：国家临床重点专科建设项目(TJZ202303)。

摘　　要：临床中进行静脉穿刺前必须使用表面消毒剂进行皮肤消毒。氯己定是常用的消毒剂,在静脉输液时氯己定随着穿刺针微量进入血液循环,可引起速发型(Ⅰ型)超敏反应。这种过敏反应常被误以为由输入的药物(如抗生素)所致,造成误诊和漏诊。文章报道1例多次静脉输液后出现过敏反应、经诊断为氯己定过敏并排除抗生素过敏的病例,以加强临床医师对氯己定过敏的认识。该例的诊治过程提示,当患者发生输液相关过敏反应时,临床医师应考虑氯己定过敏的可能。In clinical practice,the application of surface disinfectants for skin disinfection is a prerequisite for venipuncture.Chlorhexidine,a widely recognized disinfectant,is frequently employed for this purpose.However,during intravenous infusions,minute quantities of chlorhexidine can be inadvertently introduced into the bloodstream via the puncture needle,potentially precipitating immediate-type(type)hypersensitivity reactions.Regrettably,these reactions are often erroneously attributed to administered medications,such as antibiotics,which can result in both misdiagnosis and underdiagnosis.This article details a case of an allergic reaction that occurred subsequent to multiple intravenous infusions and was ultimately identified as chlorhexidine-induced after antibiotic allergy was ruled out.The objective of this report is to deepen the clinical physcians’comprehension of chlorhexidineinduced allergies in the context of infusion-related allergic reactions,thereby offering a valuable reference for accurate diagnosis and effective treatment strategies.

关 键 词：静脉输液 氯己定 过敏反应 

分 类 号：R593.1[医药卫生—内科学]