1例皮试阴性的先兆早产患者使用头孢唑林致过敏性休克的案例分析  

Case Analysis of Allergic Shock Induced by Cefazolin in One Patient with Threatened Premature Labor and Negative Skin Test

作　　者：陈国强 CHEN Guo-qiang(Pharmacy Department,Cang County Hospital,Cang County Hebei 061000,China)

机构地区：[1]沧县医院药剂科,河北沧县061000

出　　处：《抗感染药学》2024年第12期1209-1211,共3页Anti-infection Pharmacy

摘　　要：目的:分析1例皮试阴性的先兆早产患者使用头孢唑林致过敏性休克的发生和处理过程,为临床患者,尤其是孕妇的用药安全提供参考。方法与结果:患者(女,26岁)因“停经36周,阴道流水3 h”来院治疗,查体示其胎膜已破,为预防无乳链球菌感染,遂预防性予头孢唑林(皮试阴性);然而,静脉滴注30 s后,患者出现手脚发麻、胸闷、憋气、呼吸困难、呕吐、全身皮肤发绀等过敏性休克症状,遂立即停用头孢唑林,并就地抢救;其间,胎心率由110次/min降至60~80次/min,考虑胎儿窘迫,遂立即行剖宫产分娩;之后,新生儿和产妇分别转至儿科和ICU救治,数日后新生儿和产妇均康复出院;事后,根据药物不良反应关联性评价标准,头孢唑林与过敏性休克的关联性为“很可能”。结论:头孢唑林作为一种安全性较高的抗菌药物,很少引起如过敏性休克这样严重的药物不良反应,但其用药风险仍然存在,对此临床仍须做好用药安全监测,尤其是孕产妇这样的特殊群体,从而保证患者的用药安全。Objective:To analyze the occurrence and treatment process of allergic shock induced by cefazolin in a patient with threatened premature labor and negative skin test,and provide reference for clinical medication safety of patients,particularly pregnant women.Methods and Results::The patient(female,26 years old)was hospitallized due to"36 weeks of gestation and 3 hours of vaginal leakage".The physical examination revealed fetal membrane rupture.To prevent infection with Streptococcus agalactiae,cefazolin was prophylactically administered(negative skin test).However,after intravenous infusion for 30 seconds,the patient developed symptoms of allergic shock,including numbness in hands and feet,chest tightness,shortness of breath,difficult breathing,vomiting,and cyanosis.Cefazolin was immediately discontinued,and emergency resuscitation was initiated.During this period,the fetal heart rate dropped from 110 beats per minute to 60-80 beats per minute,indicating fetal distress,and the cesarean section was performed immediately.Subsequently,the newborn and the mother were transferred to the pediatric department and ICU separately for further treatment.Several days later,both the newborn and the mother fully recovered and were discharged.Following the event,based on the evaluation criterion for adverse drug reaction association,the association between cefazolin and allergic shock was considered"highly likely".Conclusion:Although cefazolin is considered a relatively safe antibacterial drug and rarely causes severe adverse drug reactions like allergic shock,its medication risk remains.Therefore,clinical medication safety should be monitored,especially for special populations such as pregnant women,so as to ensure the medication safety for patients.

关 键 词：头孢唑林 先兆早产 过敏性休克 药物不良反应 

分 类 号：R978.11[医药卫生—药品] R961[医药卫生—药学]