造影剂过敏者冠脉介入术前抗过敏疗效分析

Analysis of the effect of allergy premedication for patient allergic to contrast media undergoing percutaneous coronary intervention

目的:探讨有非离子造影剂过敏史的患者接受经皮冠状动脉介入治疗(PCI)的安全性和术前预防性抗过敏治疗的效果。方法:参考相关文献资料,分析典型病例的处理方法。结果:经术前预防性抗过敏治疗,患者PCI术中未发生过敏反应,术后第3天发生轻度迟发性过敏反应,经口服H1受体阻断剂后好转,安全出院。结论:有非离子造影剂过敏史的患者在PCI术中再次接触造影剂有较大过敏风险,预防性应用糖皮质激素可降低再过敏几率,但仍可能发生再过敏。

OBJECTIVE To discuss the safety and pharmacological prevention of anaphylactic reactions to nonionic contrast media in patients with history of adverse reactions to nonionic contrast media undergoing percutaneous coronary intervention （PCI）. METHODS A typical case and the management were discussed,and related articles were summarized. RESULTS With pharmacological prevention of anaphylactic reactions, PCI was done successfully without adverse reactions during the operation, but delayed adverse reactions occurred 3 days after PCI. Treated by H1-blocker the patient was healed and discharged. CONCLUSlON There is a considerable risk in patient with history of anaphylactic reactions to nonionic contrast media when undergoing PCI. Although the possibility of anaphytactic reaction can be decreased by steroid premedication, it cannot be obviated completely by this means.