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口服氨苄头孢菌素引起过敏性休克,国内罕见。现将我们收治一例报告如下: 患者男性,78岁,因反复咳、痰、喘30余年,加重伴咳浓痰7天,于1984年11月16日上午到我院就诊。查体发现:肺气肿症。左肺中下份散在中细湿鸣。诊断:“慢性支气管炎伴感染,肺气肿”。在选用抗生素时,考虑病人既往对青霉素、磺胺等过敏,故选用口服氨苄头孢菌素0.375克,一日四次,另加Santop(此药既往曾服,不过敏)祛痰。病人回家后即服,约15分钟后,突然感气紧、唇麻、全身痒,继之大汗、面红肿胀,立即来我院。查体:神清、烦躁、脉细微,血压％mmHg。呼吸30～40次/分,四肢凉,心音弱而不清。诊断:“过敏性休克”,给肾上腺素,氢化可的松等抗过敏,抗休克。两小时后血压正常,而渐痊愈。
Oral benzyl cephalosporins cause anaphylactic shock, rare in China. Now we receive a case report as follows: Male patients, aged 78, due to repeated cough, sputum, asthma more than 30 years, increased with cough sputum for 7 days, on November 16, 1984 morning to our hospital. Examination found: emphysema. In the left lung scattered in the small wet Ming. Diagnosis: “Chronic bronchitis with infection, emphysema.” In the selection of antibiotics, taking into account the patient’s previous allergies to penicillin, sulfa, it is the choice of oral benzylbenzene cephalosporin 0.375 grams, four times a day, plus Santop (the drug previously served, no allergies) expectorant. About 15 minutes after the patient came home, he felt a sudden feeling of tightness, lip, anesthesia, systemic itching, followed by sweating, flushed, and immediately came to our hospital. Examination: Shenqing, irritability, pulse subtle, blood pressure% mmHg. Breathe 30 ~ 40 beats / min, cold limbs, weak heart sounds unclear. Diagnosis: “anaphylactic shock” to the epinephrine, hydrocortisone and other anti-allergic, anti-shock. Normal blood pressure two hours later, and gradually recovered.