阿司匹林肠溶片致严重过敏性休克1例

Severe Anaphylaxis after Oral Aspirin: A Case Report

关键词:  阿司匹林  过敏反应  休克  抽搐  心律失常

Key words:  Aspirin  Allergy Reaction  Shock  Hyperspasmia  Arrhythmia

摘要:

1名52岁男性患者,因外伤性脾破裂行脾切除,术后11天,因血小板上升至704*10^9/L服用阿司匹林肠溶片1片(25mg/片)后不到1分钟出现严重过敏反应,包括头晕、胸闷、心前区不适、上腹疼痛、不受意识控制的排大便、恶心、呕吐、阵发性抽搐、瘙痒等一系列表现,心电监护显示心动过速(房速),血压和氧饱和度快速下降,病情变化急骤迅猛,即刻给予面罩吸氧,建立多条静脉通道扩容,镇定后全麻插管,大剂量激素抗过敏和抗休克,因病情危重,转ICU进一步治疗,1小时后病情及生命体征趋于稳定。

Abstract:

A 52-year-old male underwent splenectomy due to traumatic spleen rupture. However, he had to receive the drug to anti-platelet accumulation because of the increasing number of platelet (704*10^9/L 11th day after surgery). He received oral aspirin at initial dose of 25mg (25mg/Tab.) Unexpectedly, severe allergic reaction occurred abruptly and rapidly less than 1 minute. The subsequent symptoms as follows: dizzy, pericardium distressS,dyspnea, nausea, vomiting, upper abdominal pain, defecation without control, limbs spasm, pruritus et al. Electrocardiogram monitoring showed atrial tachycardia, dropping SaO₂(70-80%) and extremely hypotension (70/40mmHg). Emergent measuresSwere carried out based on usual experiences of training practices such as mask oxygen inhalation, setting multiple intravenous lines to ensure volume expansionScapacity, tracheal intubation under general anesthesia after valium muscle injection(5mg),amount of dexamethasone(10mg, iv)also be used to rescue patient’sSlife, and so on. The patient was transferred into ICU(Intensive care unit) ward because of the aftermath of aspirin allergy. An hour latter, the patient’s conditions improved gradually. The patient discharged home a week later after rescue.