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我院自1993年开展CT扫描工作以来,迄今已检查了14361人次,其中增强扫描1157例,仅2例出现较为严重的过敏性休克,占0.17％,现报告如下。 1 病例介绍 例1,男,49岁。临床诊断为肝内占位性变,肝癌可能。碘过敏试验阴性后静脉注射60％泛影葡胺100ml,扫描过程中病人出现恶心并吐出少量胃液,但无休克症状,扫描完毕后,病人诉胸闷、头晕、气急。查体患者面色苍白、大汗、脉搏细弱、口唇发绀、血压6/3kPa。立即给予氧气吸入、静脉注射盐酸肾上腺素1mg,50％G·S 20ml+氨茶碱0.25g+地塞米松10mg,10％G·S 200ml+多巴胺10mg静脉点滴。约10分钟后,病人面色逐渐红润,脉搏较前增强,血压回升至12/8kPa,半小时后再次测血压20/13kPa。静脉输液完毕后,病人自觉良好,护送病房。
Our hospital since 1993 to carry out CT scanning has so far checked 14361 people, including enhanced scanning of 1157 cases, only 2 cases of more severe anaphylactic shock, accounting for 0.17%, are as follows. 1 case introduction example 1, male, 49 years old. Clinical diagnosis of intrahepatic space-occupying lesions, liver cancer may. Iodine allergy test negative intravenous injection of 60% diatrizoate 100ml, the patient showed nausea during the scan and spit a small amount of gastric juice, but no symptoms of shock, the scan was completed, the patient complained of chest tightness, dizziness, shortness of breath. Physical examination patients pale, sweating, pulse weak, cyanotic lips, blood pressure 6 / 3kPa. Immediately given oxygen inhalation, intravenous injection of epinephrine hydrochloride 1mg, 50% G · S 20ml + 0.25g aminophylline + dexamethasone 10mg, 10% G · S 200ml + dopamine 10mg intravenous drip. About 10 minutes later, the patient gradually ruddy, pulse increased earlier, blood pressure rose to 12 / 8kPa, half an hour later measured blood pressure 20 / 13kPa. After intravenous infusion, the patient consciously escorted to the ward.