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患者,女,35岁,2013年1月以牙痛为主诉前来医院就诊。经X线片等检查,诊断为根尖牙周炎,予拔牙治疗,给予阿替卡因肾上腺素注射液(法国碧蓝,批号:G-9,含盐酸阿替卡因68 mg与酒石酸肾上腺素17μg)1.7 ml局麻,注射后约5 min,患者即感注射部位酸胀难忍、身冒虚汗、头晕乏力随即晕倒在地,不省人事,患者迅即被送到急救室进行抢救。体检:BP 55/35 mmHg,HR 118次/min,脸色苍白、四肢发冷、呼吸急促、脉细且弱,诊断为过敏性休克,立即给予吸O_2,平卧,抬高下肢,并迅即给予0.1%肾上腺素注射液0.5 ml iv,每15 min重复一次、地塞米松10 mg+50%葡萄糖注射液20 ml iv,间羟胺70 mg+5%葡萄糖注射液500 ml iv,异丙嗪25 mg im,约30 min后患者症状逐渐好转,生命体征平稳,面色恢复正常,无胸闷气急,无特殊主诉,BP 105/75mmHg,HR 80次/min,过敏性休克已得到纠正。留院观察12h患者无特殊不适而自动出院,第2天电话随访,患者无不适。据了解,患者既往体健,无药物过敏史和家族过敏史。
The patient, female, 35 years old, came to the hospital with a toothache chief complaint in January 2013. The X-ray examination, diagnosed as periapical periodontitis, pre-extraction tooth treatment, give articaine adrenaline injection (French blue, lot number: G-9, 68 mg of articaine hydrochloride and epinephrine tartrate 17μg) 1.7ml local anesthesia, about 5min after injection, the patient that the injection site soreness, body sweating, dizziness and fatigue then fainted, unconsciousness, the patient was immediately sent to the emergency room for rescue. Physical examination: BP 55/35 mmHg, HR 118 beats / min, pale, cold extremities, shortness of breath, fine and weak pulse, diagnosed as anaphylactic shock, immediately given inhalation O_2, supine, lower extremities, and immediately 0.1% epinephrine injection 0.5 ml iv, repeated every 15 min, dexamethasone 10 mg + 50% glucose injection 20 ml iv, hydroxylamine 70 mg + 5% glucose injection 500 ml iv, promethazine 25 mg im, about 30 min after the patient’s symptoms gradually improved, stable vital signs, looking back to normal, no chest tightness and irritability, no special complaints, BP 105 / 75mmHg, HR 80 beats / min, anaphylactic shock has been corrected. 12h patients were hospitalized without special discomfort and discharged automatically, the first two days of telephone follow-up, patients with no discomfort. It is understood that patients with previous health, no history of drug allergies and family history of allergy.