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在门诊环境中处理过敏反应。

Managing anaphylaxis in the office setting.

作者信息

Cingi Cemal, Wallace Dana, Bayar Muluk Nuray, Ebisawa Motohiro, Castells Mariana, Şahin Ethem, Altıntoprak Niyazi

机构信息

Ear, Nose and Throat (ENT) Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey.

出版信息

Am J Rhinol Allergy. 2016 Jul;30(4):118-23. doi: 10.2500/ajra.2016.30.4336.

DOI:10.2500/ajra.2016.30.4336
PMID:27456586
Abstract

BACKGROUND

Although the definition of anaphylaxis for clinical use may vary by professional health care organizations and individuals, the definition consistently includes the concepts of a serious, generalized or systemic, allergic or hypersensitivity reaction that can be life-threatening or even fatal.

METHODS

In this review, we presented the important topics in the treatment of anaphylaxis in the office setting. This review will discuss triggers and risk factors, clinical diagnosis, and management of anaphylaxis in the office setting.

RESULTS

Anaphylaxis in the office setting is a medical emergency. It, therefore, is important to prepare for it, to have a posted, written anaphylaxis emergency protocol, and to rehearse the plan regularly. In this review, we presented the important steps in managing anaphylaxis in the office. Treatment of anaphylaxis should start with epinephrine administered intramuscularly at the first sign of anaphylaxis. Oxygen and intravenous fluids may be needed for moderate-to-severe anaphylaxis or anaphylaxis that is quickly developing or if the patient is unresponsive to the first injection of epinephrine. Antihistamine therapy is considered adjunctive to epinephrine, which mainly relieves itching and urticaria. Corticosteroids, with an onset of action of 4-6 hours, have no immediate effect on anaphylaxis.

CONCLUSION

To prevent near-fatal and fatal reactions from anaphylaxis, the patient, the family, and the physician must remember to follow the necessary steps when treating anaphylaxis. In anaphylaxis, there is no absolute contraindication for epinephrine.

摘要

背景

尽管临床使用的过敏反应定义可能因专业医疗保健组织和个人而异,但该定义始终包含严重、全身性或系统性过敏或超敏反应的概念,这种反应可能危及生命甚至致命。

方法

在本综述中,我们介绍了门诊环境中过敏反应治疗的重要主题。本综述将讨论门诊环境中过敏反应的触发因素和危险因素、临床诊断及管理。

结果

门诊环境中的过敏反应是一种医疗紧急情况。因此,做好应对准备、张贴书面的过敏反应应急方案并定期演练该方案很重要。在本综述中,我们介绍了门诊管理过敏反应的重要步骤。过敏反应的治疗应在出现过敏反应的第一迹象时立即肌内注射肾上腺素。对于中度至重度过敏反应、迅速发展的过敏反应或患者对首次注射肾上腺素无反应的情况,可能需要吸氧和静脉输液。抗组胺药治疗被认为是肾上腺素的辅助治疗,主要缓解瘙痒和荨麻疹。起效时间为4至6小时的皮质类固醇对过敏反应无即刻作用。

结论

为防止过敏反应导致的近乎致命和致命反应,患者、家属和医生在治疗过敏反应时必须牢记遵循必要步骤。在过敏反应中,肾上腺素没有绝对禁忌证。

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