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目的了解及掌握双硫仑样反应的机理与双硫仑样反应的症状和处理方法。方法通过我院6年来观察到的56例双硫仑样反应病例进行回顾性分析并自行分度。轻度:表现为颜面或全身皮肤潮红,轻度头昏,心慌,无恶心、呕吐、发热、头痛等;中度:表现为头昏、头痛、心慌、恶心、呕吐、发热,但无胸痛、呼吸困难、休克;重度:表现为胸痛、呼吸困难、休克,甚至意识障碍,大小便失禁。结果56例病例中,轻度双硫仑样反应36例(占64.29%),中度双硫仑样反应15例(占26.78%),重度双硫仑样反应5例(占8.93%)。56例病例中,注射头孢菌素类药物引起者48例(其中包括注射头孢菌素类药物后注射氢化可的松发生3例),占85.71%;注射甲硝唑引起者5例,占8.93%;口服呋喃唑酮引起者3例,占5.36%。结论双硫仑样反应主要发生在男性患者,在注射头孢菌素类药物后饮酒或使用含乙醇的药品或可使机体产生乙醇的药品时发生,注射甲硝唑后或口服呋喃唑酮后饮酒亦可发生,大多数病例无需特殊治疗即可好转,但重度患者则需给氧,给予大剂量维生素C,使用抗组织胺类药物,如苯海拉明、非那根等药物,输液抗休克,纠正水、电解质紊乱等措施。
Objective To understand and master the mechanism of disulfiram-like reaction and the symptoms and treatment of disulfiram-like reaction. Methods Sixty-six cases of disulfiram-like reaction observed in our hospital over the past six years were retrospectively analyzed and self-indexed. Mild: manifested as facial or systemic skin flushing, mild dizziness, palpitation, no nausea, vomiting, fever, headache, etc .; moderate: manifested as dizziness, headache, palpitation, nausea, vomiting, fever, Breathing difficulties, shock; Severe: the performance of chest pain, difficulty breathing, shock, and even disturbance of consciousness, incontinence. Results In 56 cases, there were 36 cases (64.29%) of mild disulfiram-like reaction, 15 cases of moderate disulfiram-like reaction (26.78%) and 5 cases of severe disulfiram-like reaction (8.93%). Among the 56 cases, 48 cases were caused by cephalosporins injection (including 3 cases when hydrocortisone was injected after injection of cephalosporins), accounting for 85.71%; 5 cases were caused by metronidazole injection, accounting for 8.93 %; 3 cases caused by oral furazolidone, accounting for 5.36%. CONCLUSIONS: Disulfiram-like reactions mainly occur in male patients. Alcohol consumption occurs after alcohol injection or cephalosporin-containing drugs or alcohol-producing drugs. Metronidazole may also be administered after oral administration of furazolidone Occurred, most cases without special treatment can be improved, but severe patients are required to give oxygen, giving large doses of vitamin C, the use of antihistamines, such as diphenhydramine, phenazone and other drugs, infusion anti-shock, correct Water, electrolyte disorders and other measures.