引起过敏性休克死亡的药物及防治

Drug-induced Anaphylactic Shock or Death:Drugs and Prevention & Treatment

目的:探讨药源性过敏性休克死亡的发生原因、规律、特点,避免或减少药源性过敏性休克死亡的发生。方法:收集与分析中国生物医学文献数据库及中国医院数字图书馆期刊全文库(1994-01～2009-08)药物所致过敏性休克死亡相关的医药期刊查找原文,对文献资料进行整理、汇总,并进行分析。结果:166例过敏性休克中≤10min有82例,≤30min有37例,共119例,占总数的71.69%。患者使用引起过敏性休克死亡的药物,发生例数按药物种类排序前4位为:抗菌药物97例(占58.43%)、循环系统用药17例(占10.24%)、神经系统用药10例(占6.02%)、疫苗类7例(占4.22%)。发生例数按药品排序前3位的是:青霉素类35例、头孢菌素类20例、低分子右旋糖酐10例。结论:严格用药指征,用药前详细询问过敏史,特别是老年患者更应注意其基础疾病,密切观察用药后反应,确保用药安全。

OBJECTIVE：To probe into the causes,regularities and characteristics of drug-induced anaphylactic shock or death in an effort to avoid or reduce the incidence of drug-induced anaphylactic shock or death.METHODS：Documents on drug-induced anaphylactic shock or death searched from CBMdisc and CHDL（1994-01～2009-08） were sorted,collected and analyzed.RESULTS：Of the total 166 anaphylactic-shock cases collected,anaphylactic shock occurred within 10 min in 82 cases,and within 30 min in 37 cases,i.e a total of 119 cases（71.69%） occurred within 30 min.Of all those categories of drugs that induced anaphylactic shock or death,leading the first four places were antimicrobial drug with 97 cases（58.43%）,circulatory drugs with 17 cases（10.24%）,nervous system drugs with 10 cases（6.02%） and vaccines with 7 cases（4.22%）.The top 3 drugs that induced anaphylactic shock or death were penicillins（35 cases）,cephalosporins（20 cases） and low molecular dextran（10 cases）.CONCLUSION：It is advisable to strictly follow medication indications,obtain detailed drug allergy history before treatment.For elderly patients,special efforts should be paid to the treatment of underlying diseases and close monitoring on the advere drug reactions in an effort to ensure medicaiton safety.