卡前列素氨丁三醇子宫肌内注射致产妇过敏性休克

Anaphylactic shock following an injection of carboprost tromethamine into the uterine muscle in a parturient

1例27岁女性因产后出血,给予卡前列素氨丁三醇注射液250μg子宫肌内注射。5 min后,患者突然出现胸闷、胸痛、心慌。先后给予地塞米松、麻黄碱、甲泼尼龙静脉滴注。症状未缓解并发展为大汗、意识模糊。心电监测T波振幅增高,血压降至70/40 mm Hg(1 mm Hg=0.133 kPa)。诊断为过敏性休克。立即给予硝酸甘油及抗过敏治疗。3 h后症状逐渐缓解,血压升至100/60 mm Hg。

A 27-year-old female received an injection of carboprost tromethamine 250 μg into the uterine muscle for postpartum hemorrhage.Five minutes later,she abruptly developed chest distress,chest pain,and palpitation.An IV infusion of dexamethasone,ephedrine,and methylprednisolone were given.Her symptoms did not improve and progressed to hidrosis and confusion.ECG monitoring revealed increased T-wave amplitude,and her blood pressure decreased to 70/40 mm Hg.Anaphylactic shock was diagnosed.Nitroglycerin and anti-allergic treatment were given.Three hours later,her anaphylactic symptoms gradually improved,and her blood pressure increased to 100/60 mm Hg.