Cremer R, Kleine-Diepenbruck U, Hoppe A, Bläker F
Children's Hospital, Paediatric Clinic, Cologne, Germany.
Allergy. 1998 Jul;53(7):709-11. doi: 10.1111/j.1398-9995.1998.tb03958.x.
The effect of latex prophylaxis has not been investigated in spina bifida children, a high-risk group for latex allergy. As repeated operations have been identified as a major cause of latex sensitization, we wanted to find out whether primary latex prophylaxis during surgery could prevent latex allergy in children with spina bifida.
In December 1995, we established latex-free surgery and anesthesia for all patients with spina bifida regardless of their sensitization to latex. Twelve children born after that date (mean age 1.2 years, mean number of operations 3.3, range 1-7) were tested for specific IgE against latex until December 1997 (ImmunoCap, Pharmacia, Uppsala, Sweden) and compared with eight children born before December 1995 (mean age 1.3 years, mean number of operations 3.6, range 1-8), in whom a test for latex IgE had been done before the age of 2 years.
Before we established primary prophylaxis, three of seven children with spina bifida (38%) were sensitized to latex until the age of 2 years. After the establishment of a latex-free operating theater for spina bifida patients, none of the 12 patients were sensitized to latex despite up to seven operations in each child.
Primary latex prophylaxis during surgery can prevent latex sensitization in young spina bifida patients.
脊柱裂患儿是乳胶过敏的高危群体，但尚未对乳胶预防措施的效果进行研究。由于反复手术已被确定为乳胶致敏的主要原因，我们想了解手术期间的初次乳胶预防措施是否能预防脊柱裂患儿的乳胶过敏。
1995年12月，我们为所有脊柱裂患者建立了无乳胶手术和麻醉，无论其对乳胶是否敏感。对1995年12月之后出生的12名儿童（平均年龄1.2岁，平均手术次数3.3次，范围1 - 7次）进行了针对乳胶的特异性IgE检测，直至1997年12月（使用瑞典乌普萨拉法玛西亚公司的免疫捕获法），并与1995年12月之前出生的8名儿童（平均年龄1.3岁，平均手术次数3.6次，范围1 - 8次）进行比较，这8名儿童在2岁之前已进行过乳胶IgE检测。
在我们建立初次预防措施之前，7名脊柱裂儿童中有3名（38%）在2岁时对乳胶致敏。在为脊柱裂患者建立无乳胶手术室之后，12名患者中无一例对乳胶致敏，尽管每名儿童最多接受了7次手术。
手术期间的初次乳胶预防措施可预防年幼脊柱裂患者的乳胶致敏。
