临床药师参与1例宫腔镜术中过敏性休克的多学科会诊实践

Clinical pharmacists participated in multidisciplinary consultations for one case of anaphylactic shock during hysteroscopy

药源性过敏性休克是一种严重的药物过敏反应,由于围术期用药复杂,临床医生应警惕药源性过敏性休克的发生。该文报道了1例宫腔镜术中突发过敏性休克的病例分析及处理过程。临床药师参加多学科会诊,追溯病史,结合临床多学科讨论结果,分析该患者发生休克的原因,评价该患者所用药物与发生过敏性休克的关联性,判断过敏原可能为罗哌卡因或羟乙基淀粉,同时为术后如何确定过敏原以及快速判断术中休克原因给出会诊建议,充分体现了临床药师会诊在突发围术期过敏性休克时识别病因、判断致敏药物及治疗方案制定中的重要性。

Pharmacogenetic anaphylactic shock is a serious drug-allergic reaction.And clinicians should stay on a high alert to the occurrence of pharmacogenetic anaphylactic shock due to a great complexity of perioperative medications.Here the authors described the case analysis and management process of one case of sudden anaphylactic shock during hysteroscopy.Clinical pharmacists participated in multidisciplinary consultations,traced the medical history and analyzed the results of clinical multidisciplinary discussion to explore the cause of shock,examine the association between medications and the occurrence of anaphylactic shock.The potential allergens might be ropivacaine or hydroxyethyl starch.Consultation recommendations were offered on how to identify the allergens postoperatively and quickly determine the cause of intraoperative shock.Clinical pharmacists played vital roles of identifying the etiology,determining the sensitizing drug and formulating treatment protocols for sudden perioperative anaphylactic shock.