全身麻醉中羥乙基淀粉130/0.4致過敏性休克一例及文獻分析_West China Medical Journal

Authors：

 周裕凱 ^1,2 , 張蘭 ¹ , 李振明 ¹

1. ;
2. ;

Corresponding?author：

Keywords：

羥乙基淀粉; HES; 過敏性休克

DOI：

10.7507/1002-0179.20140027

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目的總結1例全身麻醉中羥乙基淀粉（HES）130/0.4致過敏性休克的臨床特點及治療效果。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內、外踝骨折切開復位內固定術時，靜脈輸入HES130/0.4氯化鈉注射液引起過敏性休克。檢索1979年1月－2013年1月中國期刊全文數據庫中有關HES過敏的個案報道并查閱全文，得到符合條件的文獻26篇共31例患者，其中詳述29例。結合文獻分析HES過敏的特點，探索減少其發生的方法。結果根據查閱文獻結果分析，HES引起的過敏大都程度較輕，多在輸入后即刻發生，經積極搶救預后較好。其致敏機制尚不清楚，所以減少發生的重點在預防。結論圍手術期過敏發生率低，HES過敏更為少見，麻醉醫生容易忽略該類問題，但因其發生有突發性，可危及患者生命，須提高警覺意識，及時發現，系統治療。

Citation： 周裕凱, 張蘭, 李振明. 全身麻醉中羥乙基淀粉130/0.4致過敏性休克一例及文獻分析. West China Medical Journal, 2014, 29(1): 93-95. doi: 10.7507/1002-0179.20140027 Copy

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11.	姚元章, 孫士錦, 王韜等. 國產與進口羥乙基淀粉溶液的臨床療效與不良反應比較[J]. 中國臨床藥學雜志, 2006, 15(4):209-212.
12.	孫桂斌, 杭太俊. 羥乙基淀粉130/0.4氯化鈉注射液相對分子質量及分布的測定[J]. 藥物分析雜志, 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.	張秀華, 黃宇光. 圍術期羥乙基淀粉容量治療的安全性[J]. 臨床麻醉學雜志, 2006, 22(12):937-938.

1. 張冬林, 劉東, 方淑賢, 等. 2007~2009年武漢地區血漿代用品應用分析析[J]. 醫藥導報, 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. 劉小穎, 吳新民, 薛張綱, 等. 國產與進口6%羥乙基130/0.4注射液容量治療療效和安全性的對比研究[J]. 臨床麻醉學雜志, 2009, 25(5):406-408.
11. 姚元章, 孫士錦, 王韜等. 國產與進口羥乙基淀粉溶液的臨床療效與不良反應比較[J]. 中國臨床藥學雜志, 2006, 15(4):209-212.
12. 孫桂斌, 杭太俊. 羥乙基淀粉130/0.4氯化鈉注射液相對分子質量及分布的測定[J]. 藥物分析雜志, 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. 張秀華, 黃宇光. 圍術期羥乙基淀粉容量治療的安全性[J]. 臨床麻醉學雜志, 2006, 22(12):937-938.

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West China Medical Journal

全身麻醉中羥乙基淀粉130/0.4致過敏性休克一例及文獻分析

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