酮咯酸氨丁三醇注射液致危重症哮喘急性发作1例

Acute attack of critical asthma caused by ketochromate tromethamine injection:a case report

1例67岁男性患者因右侧嵌顿性腹股沟疝手术后给予酮咯酸氨丁三醇注射液90 mg+0.9%氯化钠注射液250 mL,ivd,qd,首次给药120 min后患者出现呼吸困难、大汗淋漓,HR 120次/min,R 32次/min,血氧饱和度88%(鼻导管吸氧3 L·min^(-1)),神志淡漠,三凹征阳性,可闻及喉鸣音,双肺可闻及响亮哮鸣音。诊断为支气管哮喘急性发作(危重)。立即停药并给予地塞米松、氨茶碱注射液等治疗,1h后患者呼吸困难好转,HR 102次/min,R 28次/min,血氧饱和度100%(面罩吸氧5 L·min^(-1)),神志清楚。1 d后患者无呼吸困难,双肺未闻及哮鸣音。经关联性分析,评价本次哮喘急性发作与酮咯酸氨丁三醇注射液的因果关系为“很可能”。

A 67-year-old male patient was given ketorolac tromethamine injection(90mg)and 0.9%sodium chloride injection(250 mL)intravenously once a day after the operation of the right incarcerated inguinal hernia.The patient had dyspnea and sweating at 120 minutes after the first administration,with a heart rate of 120 times/min and a respiration rate of 32 times/min.The patient’s blood oxygen saturation was 88%(nasal catheterization with oxygen at 3 L·min^(-1)),and was lethargic,with positive triplectral signs,audible laryngeal sounds,and loud wheezing sounds in both lungs.The diagnosis was an acute attack of severe bronchial asthma.The drug was stopped and the patient was treated with dexamethasone and aminophylline injections.After 1 hour,the patient's dyspnea improved.The heart rate was 102 times/min,the breathing rate was 28 times/min,the blood oxygen saturation was 100%(oxygen absorption by mask was 5 L·min^(-1)),and his consciousness was clear.After 1 day,the patient had no dyspnea,and no wheezing sound was heard in both lungs.By correlation analysis,the causal relationship between the acute asthma attack and ketorolac ambulatol injection was evaluated as"very possible".