卡前列素氨丁三醇注射液致过敏性休克1例

A case of anaphylactic shock caused by carboprost tromethamine injection

1例33岁女性患者入院待产,孕期诊断为妊娠期糖尿病。腰麻下行子宫下段剖宫产术,术中宫体注射卡前列素氨丁三醇注射液250μg促进子宫收缩,5 min后,患者出现口舌麻木,大汗淋漓,呼吸加深加快,四肢湿冷等症状,心电监护示:HR 100次·min^(-1),血压降至80/53 mm Hg(1 mm Hg=0.133 k Pa),考虑为药源性过敏性休克。立即皮下注射肾上腺素1 mg,静脉推注地塞米松磷酸钠10 mg抗过敏,并予间羟胺20 mg升压治疗,30 min后,患者心电监护示:HR 90次·min^(-1),血压升至107/76 mm Hg,R 20次·min^(-1),呼吸平稳,患者口唇红晕,四肢回暖,抢救成功。

A 33-year-old female was hospitalized for awaiting delivery. She was diagnosed as gestational diabetes during pregnancy. Lower uterine segment cesarean section with lumbar anesthesia operation was applied after admission. During the operation, 250 μg carboprost tromethamine was injected into uterus body for promoting uterine contraction. Five minutes later, the patient developed numbness of mouth and tongue, dripping great sweat, breathing deepened to speed up, humidicool limbs and other symptoms. ECG monitoring indicated that heart rate was 100 times per minute, blood pressure dropped to 80/53 mm Hg(1 mm Hg = 0.133 k Pa), which was considered as drug-induced anaphylactic shock. Subcutaneous injection of 1 mg adrenaline and antiallergic treatment with 10 mg dexamethasone sodium phosphate were given through intravenous injection, and metaradrine was given to elevate blood pressure immediately. About 30 minutes later, ECG monitoring of the patient indicated that heart rate was 90 times per minute, blood pressure increased to 107/76 mm Hg, breathing rate was 20 times per minute. The patient recovered with smooth breath, blushed lips and warmer limbs.