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1例68岁男性患者因颈椎病、椎间盘突出、椎管狭窄、脊髓压迫症、颈髓损伤行手术治疗。手术开始后静脉注射地塞米松10 mg、苯磺顺阿曲库铵2 mg和血凝酶2 U。5 min后患者血压降至50/40 mm Hg(1 mm Hg=0.133 kPa),心率130次/min,脉搏血氧饱和度0.90,四肢及躯干出现红色皮疹。立即给予肾上腺素、甲泼尼龙、去氧肾上腺素等,同时放弃手术,缝合手术切口。10 min后患者血压升至110/65 mm Hg,生命体征渐趋稳定。3 d后再次手术,手术开始后5 h静脉注射苯磺顺阿曲库铵5 mg,5 min后患者再次出现血压下降(55/40 mm Hg),四肢及躯干出现红色皮疹。给予肾上腺素及甲泼尼龙素等抢救,20 min后血压恢复至105~115/65~70 mm Hg,1 h后手术顺利完成。
A 68-year-old male patient underwent surgery for cervical spondylosis, disc herniation, spinal stenosis, spinal cord compression, and cervical cord injury. After the start of the surgery, dexamethasone was injected intravenously at 10 mg, levobupivudine 2 mg and hemagglutinin 2 U at the beginning of the operation. After 5 minutes, the patient’s blood pressure dropped to 50/40 mm Hg (1 mm Hg = 0.133 kPa), heart rate 130 beats / min, pulse oximetry 0.90 and a red rash on his extremities and trunk. Immediately give epinephrine, methylprednisolone, phenylephrine, etc., while giving up surgery, suture surgical incision. After 10 min, the patient’s blood pressure rose to 110/65 mm Hg and the vital signs became stable. Three days later, the patients were re-operated 5 hours after the start of surgery, and 5 minutes after the start of surgery, the patient again experienced a decrease in blood pressure (55/40 mm Hg) and a red rash on the extremities and trunk. Give epinephrine and methylprednisolone and other rescue, 20 min after the blood pressure was restored to 105 ~ 115/65 ~ 70 mm Hg, 1 h after the operation was successfully completed.