多次静脉输液后出现严重过敏反应诊治一例

A case of severe allergic reaction following multiple intravenous infusion

临床中进行静脉穿刺前必须使用表面消毒剂进行皮肤消毒。氯己定是常用的消毒剂,在静脉输液时氯己定随着穿刺针微量进入血液循环,可引起速发型(Ⅰ型)超敏反应。这种过敏反应常被误以为由输入的药物(如抗生素)所致,造成误诊和漏诊。文章报道1例多次静脉输液后出现过敏反应、经诊断为氯己定过敏并排除抗生素过敏的病例,以加强临床医师对氯己定过敏的认识。该例的诊治过程提示,当患者发生输液相关过敏反应时,临床医师应考虑氯己定过敏的可能。

In clinical practice,the application of surface disinfectants for skin disinfection is a prerequisite for venipuncture.Chlorhexidine,a widely recognized disinfectant,is frequently employed for this purpose.However,during intravenous infusions,minute quantities of chlorhexidine can be inadvertently introduced into the bloodstream via the puncture needle,potentially precipitating immediate-type(type)hypersensitivity reactions.Regrettably,these reactions are often erroneously attributed to administered medications,such as antibiotics,which can result in both misdiagnosis and underdiagnosis.This article details a case of an allergic reaction that occurred subsequent to multiple intravenous infusions and was ultimately identified as chlorhexidine-induced after antibiotic allergy was ruled out.The objective of this report is to deepen the clinical physcians’comprehension of chlorhexidineinduced allergies in the context of infusion-related allergic reactions,thereby offering a valuable reference for accurate diagnosis and effective treatment strategies.