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急诊科药物诱导的过敏反应:一项前瞻性观察研究。

Drug-induced anaphylaxis in the emergency department: A prospective observational study.

作者信息

Sari Dogan Fatma, Ozaydin Vehbi

机构信息

Emergency Medicine Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Emergency Medicine Clinic, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.

出版信息

North Clin Istanb. 2021 Dec 31;8(6):595-600. doi: 10.14744/nci.2021.56667. eCollection 2021.

Abstract

OBJECTIVE

Anaphylaxis is an acute, life-threatening, systemic hypersensitivity reaction. It is usually triggered by drugs, foods, and insect stings. The primary objective of our study is to determine the factors affecting drug-induced anaphylaxis to contribute to early diagnosis and treatment in these patients.

METHODS

Patients over 18 years old who were diagnosed drug-induced anaphylaxis in the Goztepe Hospital within a period of 1 year were evaluated prospectively. Patients demographical data, etiological factors, clinical findings, and treatment information were recorded.

RESULTS

Forty-four patients were enrolled in the study of which 25 (56.8%) were female. The median age of women and men was 54 (min: 22, max 82) and 44 (min 18, max 82), respectively. Twenty-three (52%) of them had a history of anaphylaxis. The most common causes of drug-induced anaphylaxis were antibiotics (36%) and nonsteroidal anti-inflammatory drugs (18%), respectively. Adrenaline was applied to 17 (38%) of the patients in the treatment.

CONCLUSION

Antibiotics were the most common drugs causing drug-induced anaphylaxis and adrenaline was underused which is the first-line treatment in the anaphylaxis. Some clinicians refrain from administering adrenaline. The reasons underlying this approach should be investigated.

摘要

目的

过敏反应是一种急性、危及生命的全身性超敏反应。它通常由药物、食物和昆虫叮咬引发。我们研究的主要目的是确定影响药物性过敏反应的因素,以有助于对这些患者进行早期诊断和治疗。

方法

对在1年内于戈兹特佩医院被诊断为药物性过敏反应的18岁以上患者进行前瞻性评估。记录患者的人口统计学数据、病因、临床症状及治疗信息。

结果

44例患者纳入研究,其中25例(56.8%)为女性。女性和男性的年龄中位数分别为54岁(最小22岁,最大82岁)和44岁(最小18岁,最大82岁)。其中23例(52%)有过敏反应史。药物性过敏反应最常见的原因分别是抗生素(36%)和非甾体抗炎药(18%)。治疗中有17例(38%)患者使用了肾上腺素。

结论

抗生素是引起药物性过敏反应最常见的药物,且肾上腺素使用不足,而肾上腺素是过敏反应的一线治疗药物。一些临床医生避免使用肾上腺素。应调查这种做法背后的原因。

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