151例头孢哌酮类注射剂致过敏性休克的文献分析

Literature analysis of 151 cases of anaphylactic shock caused by cefoperazone injection

目的:探讨头孢哌酮类注射剂致过敏性休克的临床特点和相关因素,为临床合理用药提供参考。方法:以"头孢哌酮"和"过敏性休克"为关键词,检索CNKI、VIP和万方数据库,检索时限为各数据库自建库至2020年1月,收集由头孢哌酮类注射剂致过敏性休克的文献报道,对患者的性别、年龄、原患疾病、过敏史、皮试及用药情况、过敏性休克发生时间、临床表现和转归等进行统计分析。结果:共计纳入文献141篇,151例患者,其中男性86例(56.95%),女性65例(43.05%),青年和老年最多,原患疾病以呼吸道感染为主,有过敏史者和无过敏史者分别占11.26%和62.25%。皮试阴性后发生过敏性休克者占49.67%,涉及头孢哌酮钠舒巴坦钠、头孢哌酮钠他唑巴坦钠及头孢哌酮钠三种药物,静脉滴注为主,首次用药占87.42%。59.60%的过敏性休克发生在给药后5 min内,临床表现以多器官损伤为主,死亡率8.61%。结论:头孢菌素皮试对过敏性休克的预测价值有限,应规范头孢菌素使用,加强药学监护,确保用药安全。

Objective:To explore the clinical characteristics and the related factors of anaphylactic shock induced by cefoperazone for injection in order to provide references for rational drug use.Methods:The cases reports of anaphylactic shock caused by cefoperazone for injection before January 2020 were searched in the databases of CNKI,VIP and Wanfang by using the key words of cefoperazone and anaphylactic shock.Gender and age of the patients,primary diseases,allergic history,skin test and medication,onset time,clinical manifestations,outcom of anaphylactic shock were analyzed statistically.Results:A total of 141 literature involving 151 patients were enrolled in this study.86 cases(56.95%)were male and 65 cases(43.05%)were female.Main cases were young and elderly people.The major primary disease was respiratory tract infection.The patients with and without a history of allergy were accounted for 11.26%and 62.25%respectively.49.67%of the patients developed anaphylactic shock with the skin test results of negative,in which cefoperazone sodium and sulbactam sodium,cefoperazone sodium and tazobactam sodium and cefoperazone sodium were involved.Intravenous drip was the main route of administration and 87.42%of the patients developed anaphylactic shock during the first administration.59.60%of the patients developed anaphylactic shock within 5 minutes after administration.The main clinical manifestations of anaphylactic shock induced by cefoperazone for injection were multiple organ damage and the total mortality was 8.61%.Conclusion:It was suggested that the skin test of cephalosporin was of little value in predicting anaphylactic shock.Cephalosporin antibiotics needed to be rationally used and the pharmaceutical care should be strengthened to ensure the safety drug use.