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病员男性,61岁。于1977年4月3日静脉注射环磷酰胺0.6毫克(加生理盐水20毫升)。注射毕,病员即感头昏、眼花、气喘,继而剧烈呕吐、冷汗淋漓、烦躁不安。检查病员脸色苍白、四肢厥冷、脉细快、血压60/30毫米汞柱。当即氧气吸入,皮下注射1:1000肾上腺素0.5毫升,静脉注射地塞米松10毫克,静脉滴注多巴胺等措施,约半小时后逐步恢复。数周后病员又作青霉素皮试,皮试1～2分钟后,皮试处红晕达6厘米,并立即出现全身皮肤潮红,瘙痒,球结膜充血等过敏性反应。经采取皮下注射肾上腺素,静注地塞米松等措施后症状消失。环磷酰胺是目前临床常用的抗癌药物,其主要副反应有恶心呕吐,脱发,白细胞下降,中毒性膀胱炎,肝功能损害。少数有头昏,不安,幻觉等症状,未见有过敏性休克的报告。该病员曾对青霉素等多种药物过敏,在注射环磷酰胺后,立即出现睑色苍白,脉搏微弱,四肢厥冷,血压下降等休克表现。由此提示对某些过敏体质的病员使环磷酰胺时,需引起特别注意。
Patient male, 61 years old. On April 3, 1977 intravenous cyclophosphamide 0.6 mg (plus saline 20 ml). Injection is completed, the patient is feeling dizzy, vertigo, asthma, followed by violent vomiting, cold sweat, irritability. Check the patient pale, extremities Jueleng, pulse rapid, blood pressure 60/30 mm Hg. Immediate oxygen inhalation, subcutaneous injection of 1: 1000 0.5 ml epinephrine, intravenous dexamethasone 10 mg, intravenous drip dopamine and other measures, about half an hour after the gradual recovery. A few weeks later the patient made penicillin skin test, skin test 1 to 2 minutes later, the skin test at the flush of 6 cm, and immediate systemic flushing, itching, conjunctival hyperemia and other allergic reactions. After taking subcutaneous injection of epinephrine, intravenous dexamethasone and other measures disappeared. Cyclophosphamide is commonly used in clinical anticancer drugs, the main side effects of nausea and vomiting, hair loss, leukopenia, toxic cystitis, liver damage. A few have dizziness, anxiety, hallucinations and other symptoms, there is no report of anaphylactic shock. The patient had penicillin and other drugs allergy, injection of cyclophosphamide immediately pale pale, weak pulse, extremities Jueleng, blood pressure and other shock performance. This prompted some of the allergic patients make cyclophosphamide, the need for special attention.