静脉注射碘佛醇致过敏性休克死亡

Death from anaphylactic shock caused by intravenous injection of ioversol

1例38岁女性患者因左下肢血管畸形行左下肢顺行性深静脉造影,在静脉注射地塞米松10 mg后,以0.3 ml/s的速度静脉注射0.9%氯化钠注射液50 ml+碘佛醇注射液50 ml。注射完毕后约1 min,患者出现面色苍白、口唇发绀、胸闷、恶心、呕吐,血压测不到,无自主呼吸。心电监护显示心室颤动。即刻静脉注射地塞米松、肾上腺素,并数次静脉滴注多巴胺、异丙肾上腺素、胺碘酮、碳酸氢钠、阿托品等,给予胸外心脏按压及口对口人工呼吸、电除颤并置入临时起搏器。2 d后患者终因心室扑动抢救无效死亡。

A 38-year-old woman with left lower extremity vascular malformations received anterograde venography of deep vein of left lower limb. She was given an IV bolus of dexamethasone 10 rag, and followed by 0.9% sodium chloride injection 50 ml plus ioversol injection 50 ml at the rate of 0.3 ml per second. About 1 minute after IV bolus , the patient appeared pale, had cyanotic lips, chest stuffy, nausea, vomiting, blood pressure undeteetable and no autonomous respiration. ECG showed ventricular fibrillation. She was given an IV bolus of dexamethasone and epinephrine immediately, and IV infusion of dopamine, isoprenaline, amiodarone, sodium bicarbonate, and atropine for several times. At the same time she was given closed cardiac massage, mouth-to-mouth resuscitation and electric defibrillation, and a temporary pacemaker was implanted. Two days later, the patient finally died despite resuscitation attempts of ventricular flutter.