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儿童乳胶过敏的二级预防:结果分析

Secondary prevention of latex allergy in children: analysis of results.

作者信息

Gentili A, Lima M, Ricci G, Pigna A, Fae M, Di Lorenzo E, Masi M, Baroncini S

机构信息

Department of Paediatric Anaesthesia and Intensive Care, S. Orsola-Malpighi University Hospital, Bologna.

出版信息

Pediatr Med Chir. 2006;28(4-6):83-90.

Abstract

OBJECTIVE

Latex allergy has become an increasing and clinically important problem. Several recommendation for secondary preventive measures have been advised. The aims of the study were to illustrate the results of the latex-safe protocol and to evaluate in allergic patients the role of risk factors for the development of latex allergy.

METHODS

Latex-safe treatment was divided into the following phases: anamnestic identification, allergologic assessment, patient selection, intervention programme, preventive medication, operating room equipment, postoperative management, patient and family training, follow-up.

RESULTS

Between 1998 and 2004, 6.832 patients underwent 7.333 operations. Anamnestic and diagnostic tests showed that 26 patients had latex allergy. 44 secondary perioperative latex-safe management have been accomplished in 26 children. No allergic event or complications linked to the procedure occurred. Atopy, congenital malformations frequently associated with latex allergy and the presence of 5 or more surgical procedures were the major risk factors recognized. Six out of the 26 patients (23%) had only one risk factor (atopy). Twenty out of 26 children (77%) had several associated risk factors: 8 of them had simultaneously 9 of the 10 analysed risk factors. Our data shows that, the higher their number, the higher the gravity of the allergy.

CONCLUSIONS

Although latex allergy is a limited phenomenon, it is nevertheless quite frequent within risk groups. Most patients have simultaneously many risk factors for the development of such an allergy, and the occurrence of several risk factors increases severity of the allergy. Latex-safe perioperative management offers guarantees of safety against latex allergy phenomena.

摘要

目的

乳胶过敏已成为一个日益严重且具有临床重要性的问题。已提出了一些二级预防措施的建议。本研究的目的是阐述乳胶安全方案的结果,并评估过敏患者中乳胶过敏发生的风险因素的作用。

方法

乳胶安全治疗分为以下阶段:病史识别、变应性评估、患者选择、干预方案、预防性用药、手术室设备、术后管理、患者及家属培训、随访。

结果

1998年至2004年间,6832例患者接受了7333次手术。病史和诊断测试显示26例患者有乳胶过敏。26名儿童完成了44次围手术期二级乳胶安全管理。未发生与该操作相关的过敏事件或并发症。特应性、常与乳胶过敏相关的先天性畸形以及5次或更多次外科手术是确认的主要风险因素。26例患者中有6例(23%)仅有一个风险因素(特应性)。26名儿童中有20例(77%)有多个相关风险因素:其中8例同时存在所分析的10个风险因素中的9个。我们的数据表明,风险因素数量越多,过敏的严重程度越高。

结论

尽管乳胶过敏是一种有限的现象,但在风险群体中却相当常见。大多数患者同时有许多发生这种过敏的风险因素,多个风险因素的出现会增加过敏的严重程度。围手术期乳胶安全管理可保证预防乳胶过敏现象的安全性。

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