摘要
目的:探讨过敏性休克的发病原因和临床表现,评估现有治疗方法的有效性,以提高对过敏性休克的认识,并使过敏性休克患者得到正确处理。方法:采用回顾性观察性研究方法,选取2017年7月至2023年6月北京大学第一医院诊治的过敏性休克患者63例作为研究对象,收集包括患者基本信息、现病史、生命体征、既往史、急救处理措施及转归等临床数据,对其发生过敏性休克的原因、临床表现及急救治疗措施进行描述性统计学分析。结果:63例研究对象发生过敏性休克的原因可分为药物过敏(50.79%)、食物过敏(15.87%)、血制品过敏(11.11%)、其他(3.17%)、放射治疗(1.59%)、剧烈运动(1.59%)、血液透析(1.59%),9例(14.29%)诱因不明确。临床可表现为皮肤、呼吸系统、心血管系统、胃肠道系统、泌尿系统的异常,皮肤表现中风团样皮疹、瘙痒、红肿最为常见(79.37%),呼吸系统最常见的表现是呼吸困难(30.16%),心血管系统表现中占比最高的是血压低于90 mmHg或基线血压下降30 mmHg(100.00%)。治疗药物最常用的是拟肾上腺素(49.2%)、糖皮质激素(69.8%)、抗组胺药物(52.4%)、升压药(12.7%)和其他药物。结论:过敏性休克诱因不尽相同,临床表现复杂多样,病情严重可危及生命。临床上应该注意早期准确识别高危风险的患者,预防发生过敏性休克,一旦发生过敏性休克要及时采取相应措施以保障患者生命安全。早期诊断、及时治疗是处理过敏性休克的关键。
ObjectiveTo investigate the pathogenesis and clinical manifestations of anaphylactic shock and to evaluate the effectiveness of existing treatments,so as to improve the understanding of anaphylactic shock and to properly manage patients with anaphylactic shock.MethodsA retrospective observational study was conducted to select 63 patients with anaphylactic shock who were diagnosed and treated in Peking University First Hospital from July 2017 to June 2023 as the study objects,and the clinical data including basic information,present medical history,vital signs,past medical history,emergency treatment measures and prognosis were collected,and the causes,clinical manifestations and emergency treatment measures of anaphylactic shock were descriptively analyzed.ResultsThe causes of anaphylactic shock in 63 subjects could be divided into drug allergy(50.79%),food allergy(15.87%),blood product allergy(11.11%),others(3.17%),radiotherapy(1.59%),strenuous exercise(1.59%),hemodialysis(1.59%),and the triggers in 9 cases(14.29%)were unclear.The clinical manifestations can be abnormalities of the skin,respiratory system,cardiovascular system,gastrointestinal system and urinary system,among which the most common skin manifestations are wheal rash,itching,redness and swelling(79.37%),the most common manifestation of the respiratory system is dyspnea(30.16%),and the highest proportion of cardiovascular manifestations is blood pressure lower than 90 mmHg or baseline blood pressure drop of 30 mmHg(100.00%).The most commonly used therapeutic drugs were epinephrine(49.2%),glucocorticoids(69.8%),antihistamines(52.4%),vasopressors(12.7%),and others.ConclusionThe causes of anaphylactic shock are different,and the clinical manifestations are complex and diverse,and the condition can be severe and life-threatening.Clinically,attention should be paid to the early and accurate identification of high-risk patients,the prevention of anaphylactic shock,and the timely taking of corresponding measures to protect the life safety of patients once
作者
高雨松
彭承悦
宋晓婷
赵作涛
Gao Yusong;Peng Chengyue;Song Xiaoting;Zhao Zuotao(Department of Emergency,Peking University First Hospital,Beijing 100034,China;Department of Dermatology and Venerology,Peking University First Hospital,National Clinical Research Center for Skin and lmmune Diseases,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses,Beijing 100034,China;Peking University School of Nursing,Beijing 100191,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2024年第4期474-480,共7页
Chinese Journal of Preventive Medicine
