病例介绍患者男性,47岁。因咳嗽、咳痰2个月,胸痛20天,于1991年5月21日入院。经纤支镜检查,活检病理报告:右肺小细胞癌。给环磷酰胺、长春新碱、足叶乙甙及顺铂治疗。第一个周期给顺铂40mg加生理盐水30ml稀释后从输液器莫菲氏滴管缓缓静脉推注,每日一次,连用5天,无不良反应。第二个周期首次静脉推注顺铂40mg加生理盐水30ml后,90min后,患者突然胸闷、憋气、口唇、面部及四肢紫绀,不能平卧,肢体抽搐,两肺呼吸音低,可闻及哮鸣音,心率100次/min,心律规整。考虑是顺铂过敏反应,给氟美松10mg肌肉注射,氧气吸入,30min后效果不佳,改用肾上腺素1mg皮下注射,50％葡萄糖加40ml加氟美松10mg静脉注射,20min后症状缓解。在严密观察下,于6月20日先用5％葡萄糖500ml Case presentation Patient male, 47 years old. Because of coughing and coughing for 2 months and chest pain for 20 days, she was admitted to hospital on May 21, 1991. Fibrobronchoscopy, biopsy pathology report: Right lung small cell carcinoma. Give cyclophosphamide, vincristine, etoposide and cisplatin for treatment. The first cycle was diluted intravenously with cisplatin 40 mg plus normal saline 30 ml and intravenously injected intravenously from the infusion set Murphy’s dropper once daily for 5 days without adverse reactions. After the first intravenous injection of cisplatin 40 mg plus normal saline 30 ml for the first time in the second cycle, the patient suddenly suffered chest tightness, belching, lips, facial and limb purpura, could not lie supine, had convulsions, and had low breath sounds in both lungs. Beep, heart rate 100 beats/min, regular heart rate. Consider the cisplatin allergic reaction, to intramuscular injection of 10mg of dexamethasone, oxygen inhalation, the effect is poor after 30min, use epinephrine 1mg subcutaneous injection, 50% glucose plus 40ml flumethasone 10mg intravenous injection, 20 minutes after the symptomatic remission. Under close observation, use 5% glucose 500ml on June 20