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[类过敏反应的院外治疗]

[Out-of-Hospital treatment of anaphylactoid reactions].

作者信息

Walther A, Böttiger B W

机构信息

Klinik für Anaesthesiologie, Universitätsklinikum Heidelberg.

出版信息

Internist (Berl). 2004 Mar;45(3):296-304. doi: 10.1007/s00108-003-1142-y.

Abstract

The term anaphylactoid reaction is a generic term used for allergic reactions with symptoms of anaphylaxis. Anaphylaxis is a severe systemic allergic reaction that is potentially fatal. It requires prompt recognition and immediate management. The syndrome can affect virtually any organ in the body, although reactions involving the respiratory, the cardiovascular, the cutaneous and the gastrointestinal systems are most common. Anaphylaxis is caused by the release of mediators from mast cells and basophiles. Reactions typically follow a uniphasic course; however, 20% will be biphasic in nature. The second phase usually occurs after an asymptomatic period of 10 hours in the mean. Adrenaline is the pharmacological treatment of choice and should be used in all patients showing signs of beginning blood pressure decrease or upper airway oedema. Further therapy in the treatment of anaphylaxis includes circulatory support, volume therapy, antihistamines and corticosteroids. Post-treatment observation of these patients is absolutely necessary. Once recovered, patients should be hospitalized and monitored for the following 24-48 hours.

摘要

类过敏反应这一术语是用于具有过敏反应症状的过敏反应的通用术语。过敏反应是一种严重的全身性过敏反应,有潜在致命性。它需要迅速识别并立即处理。该综合征实际上可影响身体的任何器官,不过涉及呼吸、心血管、皮肤和胃肠系统的反应最为常见。过敏反应是由肥大细胞和嗜碱性粒细胞释放介质所引起。反应通常呈单相病程;然而,20%本质上会呈双相病程。第二阶段通常平均在10小时的无症状期后出现。肾上腺素是首选的药物治疗,应在所有出现血压开始下降或上呼吸道水肿迹象的患者中使用。过敏反应治疗的进一步措施包括循环支持、容量治疗、抗组胺药和皮质类固醇。对这些患者进行治疗后观察绝对必要。一旦康复,患者应住院并在接下来的24至48小时内接受监测。

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