Temiño Viviana M, Peebles R Stokes
The Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA.
Am J Med. 2008 Apr;121(4):282-6. doi: 10.1016/j.amjmed.2007.09.024.
Angioedema manifests as episodes of localized swelling in the dermis and submucosa. The key to successful management is detection and avoidance of triggers, early recognition of attacks, and aggressive airway management when warranted. Review of a patient's medication list may identify drugs that include angiotensin-converting enzyme inhibitor or angiotensin receptor blockers as the cause. Initial treatment in a patient presenting with most forms of angioedema includes antihistamines and glucocorticoids if required. Epinephrine should be administered if there is concern for laryngeal edema. Patients who have a known history of hereditary angioedema should receive C1 esterase inhibitor concentrate or fresh-frozen plasma.
血管性水肿表现为真皮和黏膜下层的局部肿胀发作。成功管理的关键在于检测并避免触发因素、早期识别发作情况,以及在必要时积极进行气道管理。查看患者的用药清单可能会找出以血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂为病因的药物。对于大多数血管性水肿形式的患者,初始治疗包括必要时使用抗组胺药和糖皮质激素。如果担心出现喉头水肿,应给予肾上腺素。有遗传性血管性水肿已知病史的患者应接受C1酯酶抑制剂浓缩物或新鲜冷冻血浆治疗。