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庆大霉素为临床广用的抗菌素,发生过敏性休克较罕见。国内文献报道新疆、湖南各1例,辽宁2例。最近,我们遇到1例因肌肉注射庆大霉素发生严重过敏性休克致死,并具有病理解剖的资料。特报道以供参考。病例报告病者李××,男,42岁,教师。因咽喉疼痛3小时,无发热、咳嗽、声嘶等症状,步行来院五官科急诊。检查:神志清楚、对答好,无声嘶,无呼吸困难,咽充血(++),左侧咽后壁稍肿胀,诊断为急性咽炎。下午9时许在门诊肌肉注射庆大霉素8万单位,注射后即步行约15分钟回家,到家后便感胸闷、呼吸困难、未服其他药物,即由家人用自行车推送回院五官科病房急诊。当时病者已有明显发绀、呼吸困难,但未见三凹征,不能讲话,烦躁,脉搏摸不到。10时30分即予以吸氧,数分钟后,出现呼吸停止,即行人工呼吸及气管切开,当气管切开时,自气管套喷出的气流和分泌物很少,加用简易人工呼吸器持续维持人工呼吸,感到要加较大压力才能维持气体交换,检查气管套并无阻塞,呼吸恢复约3分钟后(10时55分),又发生呼吸、心跳停止,瞳孔散大,即行人工
Gentamicin is widely used in clinical antibiotics, the occurrence of anaphylactic shock is rare. Domestic literature reported Xinjiang, Hunan in 1 case, Liaoning 2 cases. Recently, we encountered 1 case of severe anaphylactic shock due to intramuscular gentamicin injection, with pathological anatomy. Special report for reference. Case report Lee × ×, male, 42 years old, teacher. Due to sore throat for 3 hours, no fever, cough, hoarseness and other symptoms, walking to the hospital ENT emergency. Check: conscious, good answer, silent hoarseness, no breathing difficulties, pharyngeal congestion (++), slightly swollen posterior pharyngeal wall on the left, the diagnosis of acute pharyngitis. At 9 o’clock in the outpatient intramuscular injection of gentamicin 80,000 units, about 15 minutes after walking back home after injection, home feeling chest tightness, difficulty breathing, not taking other drugs, that is, by family members to push back to the hospital ENT Ward emergency. At that time, the patient had obviously cyanosis and difficulty breathing. However, he did not see the three recess sign, and could not speak, irritability or pulse. 10:30 to be oxygen, a few minutes after the respiration stopped, that is, artificial respiration and tracheotomy, when the tracheal incision, air jets and secretions discharged from the trachea is very small, plus simple artificial respirator Continue to maintain artificial respiration, feel more pressure to maintain gas exchange, check the tracheal sheath and no obstruction, resuscitation about 3 minutes after (10:55), respiration, heartbeat, dilated pupils, the line of labor