Sasaki A, Hashimoto Y, Eba Y, Fudeta H, Shiozawa S, Imai Y
Department of Anesthesiology, Tohoku University School of Medicine, Sendai.
Masui. 1990 Aug;39(8):1050-4.
A 55-yr-old male with carcinoma of bladder received transurethral coagulation (TUC) under epidural anesthesia. A few min after the operation, he went into anaphylactic shock during irrigation of urinary bladder with thrombin solution. The symptoms were epigastralgia, circulatory collapse, skin rashes over the whole body and dyspnea. Oxygen inhalation and iv administration of epinephrine and steroid were performed, and his general condition improved within several hours. On the 2nd day after recovery from the anaphylactic shock, the patient received prick test on several agents which he had been given during operation. Prick test and RAST (radioallergosorbent test) on thrombin were positive. Based on our experience, thrombin may act to produce anaphylactic reaction. Although anaphylactic shock following topical thrombin is rare, we feel that thrombin should not be used without prick test.
一名55岁的膀胱癌男性患者在硬膜外麻醉下接受了经尿道凝血术（TUC）。术后几分钟，在用凝血酶溶液冲洗膀胱时，他发生了过敏性休克。症状包括上腹部疼痛、循环衰竭、全身皮疹和呼吸困难。给予吸氧以及静脉注射肾上腺素和类固醇，数小时内其一般状况有所改善。过敏性休克恢复后的第二天，患者对手术期间给予的几种药物进行了点刺试验。凝血酶的点刺试验和放射性变应原吸附试验（RAST）呈阳性。根据我们的经验，凝血酶可能会引发过敏反应。尽管局部使用凝血酶后发生过敏性休克很罕见，但我们认为在未进行点刺试验的情况下不应使用凝血酶。
