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青霉素用药7天后发生变态反应迟发型！

2017-11-18 李俊杰 东营市河口区河口街道卫生院 乡村白大褂

青霉素变态反应迟发过敏休克
关注

青霉素是广谱抗生素，疗效高，低毒性，被广泛用于临床。变态反应速发型，临床经常遇到。但是其变态反应迟发型容易引起忽视，所以在临床用药时一定严密监测，确保用药安全。

青霉素是广谱抗生素，疗效高，低毒性，被广泛用于临床。变态反应速发型，临床经常遇到。但是其变态反应迟发型容易引起忽视，所以在临床用药时一定严密监测，确保用药安全。

案例

张某，女，28岁，因预防类风湿性心内膜感染，选择静脉输注青霉素480万IU.bid.同一批号青霉素输液第七天，输液一分钟左右，患者出现大汗淋漓，胸闷，既之休克，考虑青霉素过敏休克！

马上开始抢救，首先停用青霉素，立即使患者去枕平卧，头偏向一侧保持呼吸道通畅，马上皮下注射1%盐酸肾上腺素0.5mg，地塞米松10mg静脉推注，开放另外的静脉通道输液补充血容量，鼻塞法吸氧40%氧流量4.0升/分等急救处理。约两分钟后患者恢复意识，抢救成功。



分析

上述案例就属于青霉素变态反应迟发型。青霉素引起多种变态反应，按反应时间可分为速发型和迟发型。速发型来势凶猛，症状重，医护人员十分警惕。而迟发型变态反应因起病迟缓，反应于药物关系不显着，往往不被人们重视，容易造成医疗事故，所以在临床用药时更得引起警惕！

预防措施：

皮试液配置和使用规范，输入药液要现用现兑，严格遵守无菌操作规程，防止溶液不稳定被水解及污染，严格掌握青霉素用药指征，加强用药后追踪观察，时刻警惕变态反应迟发型的发生！

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    2018-04-24 ms55066533437992

    #变态反应#

    0

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    2018-05-20 yb6560

    #迟发型#

    0

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createdTime=Sat Nov 18 07:13:08 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262156, encodeId=9fac2621567f, content=学习了有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Nov 18 07:07:35 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-19 sunyl09

    #青霉素#

    0

  4. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262171, encodeId=13642621e130, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Nov 18 07:22:41 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262163, encodeId=b63b262163ca, content=好好好好好好好好就, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Sat Nov 18 07:13:08 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262156, encodeId=9fac2621567f, content=学习了有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Nov 18 07:07:35 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-19 海之蓝

    学习

    0

  5. 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    2017-11-18 惠映实验室

    学习了.谢谢.

    0

  6. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262171, encodeId=13642621e130, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sat Nov 18 07:22:41 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262163, encodeId=b63b262163ca, content=好好好好好好好好就, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Sat Nov 18 07:13:08 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262156, encodeId=9fac2621567f, content=学习了有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Nov 18 07:07:35 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-18 执着追梦

    谢谢.谢谢分享

    0

  7. 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createdTime=Sat Nov 18 07:13:08 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262156, encodeId=9fac2621567f, content=学习了有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Nov 18 07:07:35 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-18 李东泽

    很好的学习材料.对临床和科研都有很大帮助作用.水滴石穿.不断积累.

    0

  8. 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createdTime=Sat Nov 18 07:13:08 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262156, encodeId=9fac2621567f, content=学习了有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Nov 18 07:07:35 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-18 明月清辉

    谢谢分享.学习了

    0

  9. 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    2017-11-18 yjs木玉

    好好好好好好好好就

    0

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    2017-11-18 飛歌

    学习了有帮助

    0

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