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[通过皮肤点刺试验确诊的三例围手术期过敏反应]

[Three cases of perioperative anaphylaxis identified by using skin-prick tests].

作者信息

Inoue Kazuyoshi, Kawanishi Hiroyuki, Nakamura Hitoshi, Yatsu Yuichi, Takebe Sawako, Nagai Akihiro, Matsuda Rikiya, Hirasaki Akihito

出版信息

Masui. 2014 Nov;63(11):1276-9.

Abstract

We encountered three cases of perioperative anaphylaxis identified by using skin-prick tests. [Case 1] A 43-year-old woman was scheduled to undergo elective laparoscopic subtotal gastrectomy under general anesthesia for gastric tumor. However, the procedure was cancelled because of anaphylaxis that was noted at the beginning of the surgery. We performed a skin-prick test and observed a positive reaction with ro- curonium. [Case 2] A 79-year-old man underwent laparoscopic colon resection under general anesthesia for colon cancer. Anaphylaxis was noted at the end of surgery. We performed a skin-prick test and observed a positive reaction with sugammadex. [Case 3] A 44-year-old woman underwent myomectomy under general anesthesia for a uterine fibroid. Anaphylaxis was noted approximately 10 minutes after the beginning of surgery. We performed a skin-prick test and noted a positive reaction with latex. It is difficult to identify the reason for anaphylaxis during surgery under general anesthesia because various agents may be responsible for the anaphylactic reaction. Anaphylaxis during surgery is a rare but life-threatening event and it is important to identify the causative agent for anaphylaxis.

摘要

我们通过皮肤点刺试验确诊了3例围手术期过敏反应。[病例1] 一名43岁女性计划在全身麻醉下接受择期腹腔镜胃大部切除术以治疗胃肿瘤。然而,手术因在手术开始时出现过敏反应而取消。我们进行了皮肤点刺试验,观察到对罗库溴铵呈阳性反应。[病例2] 一名79岁男性在全身麻醉下接受腹腔镜结肠癌切除术。手术结束时出现过敏反应。我们进行了皮肤点刺试验,观察到对舒更葡糖钠呈阳性反应。[病例3] 一名44岁女性在全身麻醉下接受子宫肌瘤切除术。手术开始约10分钟后出现过敏反应。我们进行了皮肤点刺试验,观察到对乳胶呈阳性反应。在全身麻醉下的手术过程中很难确定过敏反应的原因,因为各种药物都可能导致过敏反应。手术期间的过敏反应是一种罕见但危及生命的事件,识别过敏反应的致病因素很重要。

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