全身麻醉中羟乙基淀粉130/0.4致过敏性休克一例及文献分析_West China Medical Journal

Authors：

 周裕凯 ^1,2 , 张兰 ¹ , 李振明 ¹

1. ;
2. ;

Corresponding author：

Keywords：

羟乙基淀粉; HES; 过敏性休克

DOI：

10.7507/1002-0179.20140027

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目的总结1例全身麻醉中羟乙基淀粉（HES）130/0.4致过敏性休克的临床特点及治疗效果。方法 1例老年女性患者于2012年6月2日在全身麻醉下行右内、外踝骨折切开复位内固定术时，静脉输入HES130/0.4氯化钠注射液引起过敏性休克。检索1979年1月－2013年1月中国期刊全文数据库中有关HES过敏的个案报道并查阅全文，得到符合条件的文献26篇共31例患者，其中详述29例。结合文献分析HES过敏的特点，探索减少其发生的方法。结果根据查阅文献结果分析，HES引起的过敏大都程度较轻，多在输入后即刻发生，经积极抢救预后较好。其致敏机制尚不清楚，所以减少发生的重点在预防。结论围手术期过敏发生率低，HES过敏更为少见，麻醉医生容易忽略该类问题，但因其发生有突发性，可危及患者生命，须提高警觉意识，及时发现，系统治疗。

Citation： 周裕凯, 张兰, 李振明. 全身麻醉中羟乙基淀粉130/0.4致过敏性休克一例及文献分析. West China Medical Journal, 2014, 29(1): 93-95. doi: 10.7507/1002-0179.20140027 Copy

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11.	姚元章, 孙士锦, 王韬等. 国产与进口羟乙基淀粉溶液的临床疗效与不良反应比较[J]. 中国临床药学杂志, 2006, 15(4):209-212.
12.	孙桂斌, 杭太俊. 羟乙基淀粉130/0.4氯化钠注射液相对分子质量及分布的测定[J]. 药物分析杂志, 2009, 29(10):1643-1645.
13.	Lieberman P. Anaphylactic reactions during surgical and medical procedures[J]. J Allergy ClinImmunol. 2002, 110(2 Suppl):S64-69.
14.	张秀华, 黄宇光. 围术期羟乙基淀粉容量治疗的安全性[J]. 临床麻醉学杂志, 2006, 22(12):937-938.

1. 张冬林, 刘东, 方淑贤, 等. 2007~2009年武汉地区血浆代用品应用分析析[J]. 医药导报, 2010, 29(12):1656-1658.
2. Laxenaire MC. Epidemiologie des reactions anaphylactoidesper-anesthesiques:quatriemeenquetemulticentrique (juillet 1994-decembre 1996)[J]. Ann FrAnesthReanim, 1999, 18(7):796-809.
3. Fasting S, Gisvold SE. Serious intraoperative problems:a five-year review of 83844 anesthetics[J]. Can J Anaesth, 2002, 49(6):545-553.
4. Laxenaire MC, Mertes PM, Benabes B, et al. Anaphylaxis during anaesthesia:results of a two-year survey in France[J]. Br JAnaesth, 2001, 87(4):549-558.
5. Laxenaire MC, Charpentier C, Feldman L. Anaphylactoid reactions to colloid plasma substitutes:incidence, risk factors, and mechanisms-a French multicenter prospective study[J]. Ann FrAnesthReanim, 1994, 13(3):301-310.
6. Mishler JM. The structure and chemistry of hydroxyethyl starch. Pharmacology of hydroxyethylstarch[M]. Oxford:Oxford University Press, 1982:1-30.
7. Kraft D, Sirtl C, Laubenthal H, et al. No evidence for the existence of preformed antibodies against hydroxyethyl starch in man[J]. Eur Surg Res, 1992, 24(3):138-142.
8. Dieterich HJ, Kraft D, Sirtl C, et al. Hydroxyethyl starch antibodies in humans:incidence and clinical relevance[J]. Anesth Analg, 1998, 86(5):1123-1126.
9. Kroigaard M, Garvey LH, Gillberg L,et al. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia[J]. Acta Anaesthesiol Scand, 2007, 51(6):655-670.
10. 刘小颖, 吴新民, 薛张纲, 等. 国产与进口6%羟乙基130/0.4注射液容量治疗疗效和安全性的对比研究[J]. 临床麻醉学杂志, 2009, 25(5):406-408.
11. 姚元章, 孙士锦, 王韬等. 国产与进口羟乙基淀粉溶液的临床疗效与不良反应比较[J]. 中国临床药学杂志, 2006, 15(4):209-212.
12. 孙桂斌, 杭太俊. 羟乙基淀粉130/0.4氯化钠注射液相对分子质量及分布的测定[J]. 药物分析杂志, 2009, 29(10):1643-1645.
13. Lieberman P. Anaphylactic reactions during surgical and medical procedures[J]. J Allergy ClinImmunol. 2002, 110(2 Suppl):S64-69.
14. 张秀华, 黄宇光. 围术期羟乙基淀粉容量治疗的安全性[J]. 临床麻醉学杂志, 2006, 22(12):937-938.

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全身麻醉中羟乙基淀粉130/0.4致过敏性休克一例及文献分析

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