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[开具肾上腺素自动注射器(EpiPen)的食物过敏儿童的状况]

[Status of children with food allergy who were prescribed an adrenaline autoinjector (epipen)].

作者信息

Mukaida Kumiko, Kusunoki Takashi, Nozaki Fumihito, Hiejima Ikuko, Hayashi Anri, Kumada Tomohiro, Miyajima Tomoko, Fujii Tatsuya

机构信息

Department of Pediatrics, Shiga Medical Center for Children; Kumiko Allergy Clinic.

Department of Pediatrics, Shiga Medical Center for Children.

出版信息

Arerugi. 2014 May;63(5):686-94.

Abstract

PURPOSE

Both to evaluate the characteristics of food allergic children who were prescribed an adrenaline autoinjector and to assess whether it was used appropriately.

METHODS

The characteristics of food allergic children who were prescribed an adrenaline autoinjector were investigated. Among these children, those who experienced severe anaphylaxis due to inadvertent ingestion were analyzed, as was whether and how the autoinjector was used.

RESULTS

An adrenaline autoinjector was prescribed to 139 food allergic children, most often for egg, followed by milk and wheat allergies. Concomitant bronchial asthma, atopic dermatitis, and food allergies of other causes were present in 49 (35.3%), 68 (48.9%), and 102 cases (73.4%), respectively. The most frequent organ involved in anaphylaxis was the skin (94.2%), followed by the respiratory (78.5%), digestive (28.1%), and circulatory (24.8%) organs. A total of 24 cases experienced severe anaphylaxis after the prescription; however, the autoinjector was used in only six (25%) of those cases. The reasons given for lack of use included fear of use, unavailability of the autoinjector, prior improvement with use of an oral antihistamine and immediate visit to a hospital emergency department in eight, five, three and one case, respectively.

CONCLUSION

These results suggest that the autoinjector is often not used appropriately after prescription. Therefore, children and their caregivers require more effective guidance on proper adrenaline autoinjector use.

摘要

目的

评估开具肾上腺素自动注射器的食物过敏儿童的特征,并评估其使用是否恰当。

方法

对开具肾上腺素自动注射器的食物过敏儿童的特征进行调查。在这些儿童中,分析因意外摄入导致严重过敏反应的儿童,以及自动注射器的使用情况(是否使用以及如何使用)。

结果

为139名食物过敏儿童开具了肾上腺素自动注射器,最常见的过敏食物是鸡蛋,其次是牛奶和小麦过敏。分别有49例(35.3%)、68例(48.9%)和102例(73.4%)伴有支气管哮喘、特应性皮炎和其他原因的食物过敏。过敏反应中最常累及的器官是皮肤(94.2%),其次是呼吸道(78.5%)、消化道(28.1%)和循环系统(24.8%)。总共24例在开具处方后发生严重过敏反应;然而,其中只有6例(25%)使用了自动注射器。未使用的原因包括害怕使用、自动注射器无法获取、使用口服抗组胺药后症状先有改善以及分别有8例、5例、3例和1例直接前往医院急诊科就诊。

结论

这些结果表明,开具处方后自动注射器的使用往往不恰当。因此,儿童及其护理人员需要在肾上腺素自动注射器的正确使用方面获得更有效的指导。

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