自动注射器意外注射肾上腺素的处理方法：一例病例报告
Management options for accidental injection of epinephrine from an autoinjector: a case report.
作者信息
Mathez Christian, Favrat Bernard, Staeger Philippe
机构信息
Department of Ambulatory Care and Community Medicine, University of Lausanne Bugnon 44, 1011 Lausanne-CHUV Switzerland.
出版信息
J Med Case Rep. 2009 Jun 8;3:7268. doi: 10.4076/1752-1947-3-7268.
INTRODUCTION
Epinephrine autoinjector devices are used with increasing frequency to treat severe anaphylactic reactions. Accidental injection, usually involving a finger, is a potential complication.
CASE PRESENTATION
A physician in a Family Practice training program accidentally injected epinephrine into his left thumb while reading the operating instructions of an autoinjector (Epipen((R))). He developed swelling, pallor, and pain in the thumb. Treatment included topical nitroglycerin, oral vasodilators and warming of the thumb. As expected, none caused an immediate response; however, after 8 hours, the thumb was pink and warm. There was full recovery 2 months after the accident. We reviewed the treatment of accidental epinephrine injection, and found that the use of parenteral adrenergic alpha blocker phentolamine would have produced immediate recovery.
CONCLUSIONS
All health professionals concerned with the use of epinephrine autoinjectors should receive adequate instruction on their use. A regimen for management of accidental epinephrine injection, in particular the use of phentolamine, should be emphasized.
引言
肾上腺素自动注射器用于治疗严重过敏反应的频率日益增加。意外注射，通常涉及手指，是一种潜在的并发症。
病例报告
一名家庭医学培训项目的医生在阅读自动注射器（EpiPen((R))）的操作说明时，意外将肾上腺素注射到他的左手拇指。他的拇指出现肿胀、苍白和疼痛。治疗包括局部使用硝酸甘油、口服血管扩张剂以及拇指保暖。正如预期的那样，这些治疗均未立即产生效果；然而，8小时后，拇指恢复红润且温暖。事故发生2个月后完全康复。我们回顾了意外肾上腺素注射的治疗方法，发现使用胃肠外肾上腺素α受体阻滞剂酚妥拉明可立即恢复。
结论
所有涉及使用肾上腺素自动注射器的卫生专业人员都应接受关于其使用的充分指导。应强调意外肾上腺素注射的处理方案，特别是酚妥拉明的使用。
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