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儿童过敏反应的急性治疗。

Acute treatment of anaphylaxis in children.

机构信息

BC Children's Hospital, Department of Pediatrics, Room K4-226, Ambulatory Care Bldg, 4480 Oak St, Vancouver, BC V6H 3V4.

出版信息

Can Fam Physician. 2013 Jul;59(7):740-1.

PMID:23851537
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3710037/
Abstract

QUESTION

A 3-year-old was rushed to my office after eating a friend's chocolate bar that contained nuts. He immediately developed urticaria on his face and swelling of his lips, and he had a persistent cough. What is the best treatment for a child with anaphylaxis? Should this family receive a prescription for an epinephrine autoinjector device?

ANSWER

Intramuscular epinephrine injection is a safe and effective treatment of anaphylaxis in children. Children with systemic allergic reactions should carry epinephrine autoinjectors at all times, and should certainly have one with them at school. In order for epinephrine autoinjectors to be effective, children and their families need to be educated on how to properly use the devices, as well as keep in mind the product's expiration date.

摘要

问题

一个 3 岁的孩子在吃了含有坚果的朋友的巧克力棒后被紧急送往我的办公室。他的脸立即出现荨麻疹,嘴唇肿胀,并持续咳嗽。过敏反应的最佳治疗方法是什么?这个家庭应该开肾上腺素自动注射器吗?

答案

肌内注射肾上腺素是儿童过敏反应的安全有效治疗方法。有全身性过敏反应的儿童应随时携带肾上腺素自动注射器,并且在学校也应随身携带。为了使肾上腺素自动注射器有效,儿童及其家人需要接受有关如何正确使用这些设备的教育,并且要记住产品的有效期。

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本文引用的文献

1
Management of anaphylaxis in children.儿童过敏反应的管理。
Pediatr Emerg Care. 2008 Dec;24(12):861-6; quiz 867-9. doi: 10.1097/PEC.0b013e31818ea116.
2
Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium.过敏反应的定义与管理第二次研讨会:总结报告——第二届美国国立过敏与传染病研究所/食物过敏与过敏反应网络研讨会
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First-aid treatment of anaphylaxis to food: focus on epinephrine.食物过敏反应的急救治疗:聚焦于肾上腺素。
J Allergy Clin Immunol. 2004 May;113(5):837-44. doi: 10.1016/j.jaci.2004.01.769.
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Adrenaline in the treatment of anaphylaxis: what is the evidence?肾上腺素治疗过敏反应:证据有哪些?
BMJ. 2003 Dec 6;327(7427):1332-5. doi: 10.1136/bmj.327.7427.1332.
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Diagnosis and management of anaphylaxis.过敏反应的诊断与处理
CMAJ. 2003 Aug 19;169(4):307-11.
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Use of epinephrine in the treatment of anaphylaxis.肾上腺素在过敏反应治疗中的应用。
Curr Opin Allergy Clin Immunol. 2003 Aug;3(4):313-8. doi: 10.1097/00130832-200308000-00013.
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Anaphylaxis and emergency treatment.过敏反应与急救治疗。
Pediatrics. 2003 Jun;111(6 Pt 3):1601-8.
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EpiPen Jr versus EpiPen in young children weighing 15 to 30 kg at risk for anaphylaxis.针对体重15至30公斤有过敏反应风险的幼儿,比较儿童型肾上腺素自动注射器(EpiPen Jr)与肾上腺素自动注射器(EpiPen)的效果。
J Allergy Clin Immunol. 2002 Jan;109(1):171-5. doi: 10.1067/mai.2002.120758.
9
Can epinephrine inhalations be substituted for epinephrine injection in children at risk for systemic anaphylaxis?对于有全身性过敏反应风险的儿童,肾上腺素吸入剂能否替代肾上腺素注射剂?
Pediatrics. 2000 Nov;106(5):1040-4. doi: 10.1542/peds.106.5.1040.
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Biphasic anaphylactic reactions in pediatrics.儿科双相过敏反应
Pediatrics. 2000 Oct;106(4):762-6. doi: 10.1542/peds.106.4.762.