过敏症Anaphylaxis

过敏症Anaphylaxis 过敏症 Anaphylaxis Prepared by: Dr. Terry Hunt Translated by Dr. Ren Xiaoling 病因/发病机理 Cause & Pathogenesis , 1型过敏反应 Type 1 anaphylactic reaction , 最常见的原因是注射生物制品引起过敏反应 Most common cause is reaction to the injection of a biological product , 在牛，肺脏是靶器官 In cattle, the lung is the target organ 危险因素 Risk Factors , 反复注射生物制品 Repeated injection of biological product 临床症状 Clinical Findings , 急性发作—常发生于注射后20分钟内 Acute onset – usually within 20 minutes of injection , 焦虑，痛苦不安 Anxious and distressed , 呼吸困难—张嘴呼吸，喷鼻，咳嗽 Dyspnea – open mouthed, flared nostrils, cough , 可有荨麻疹和水肿 May be urticaria and edema , 发展成发绀，卧地不起甚至死亡Progresses to cyanosis, recumbency and death 诊断 Diagnosis , 最近的注射史 Recent history of injection , 临床症状包括听诊有破裂音 Clinical signs include crackles 鉴别诊断 Differential Diagnosis , 急性肺炎 Acute pneumonia 实验室和病理学诊断Laboratory and Pathology , 尸体剖检—血管充盈 Post-mortem – vascular engorgement , 肺水肿，也可引起肺气肿 Pulmonary edema and maybe emphysema 治疗 Treatment , 立即静脉注射肾上腺素 Emergency injection of epinephrine (adrenaline) IV , 缓慢静脉注射1:10,000 5 ml Slow IV injection of 5 ml of 1:10,000 , 肌肉或皮下注射1:1000 IM or SQ of 1:1000 , 15分钟后重复 Repeat in 15 minutes , 类固醇 Steroids 预后情况 Prognosis , 谨慎—取决于治疗是否及时 Guarded – depends on how soon treated 预防 Prevention & Control , 避免注射有引起过敏性休克史的药物 Avoid injecting drugs with a history of causing anaphylactic shock