【每周一问】NO.73-过敏反应与类过敏反应（part5）

The pathophysiology of anaphylaxis, the difference between anaphylactic and anaphylactoid reactions, and their management.
This week we conclude our discussion of anaphylaxis, and will discuss the treatment of an anaphylactic episode during an anesthetic.
You are in the middle of the anesthetic for a total colectomy when you notice that the patient's skin is red and blotchy and his blood pressure is 85/40 (it was 110-120s/50-60s throughout most of the procedure). There are no other hemodynamic changes and there has not been any major change in what the surgeons are doing.
1.  What is the likelihood that this is an episode of anaphylaxis?
2.  How do you treat an episode of intraoperative anaphylaxis?
3.  What would you tell this patient after he is recovered and conscious?
4.  Is there any role for premedication prior to a future anesthetic?





过敏反应的病理生理，过敏反应与类过敏反应的区别及其治疗
我们对过敏反应的讨论进行总结，并讨论麻醉中偶发过敏反应的处理。
全结肠切除术麻醉中发现患者皮肤出现发红并有斑片状改变，血压为85/40mmHg（术中大多数时间内维持在110-120/50-60 mmHg），没有其它血流动力学变化，也没有外科重大操作。

1、  该过敏反应的可能原因是什么？
2、  如何治疗该手术中出现的过敏反应？
3、  在患者苏醒后如何告知患者？
4、  麻醉之前使用术前用药是否有用？






(f)(f)(f)(b)(b) 本版发展 我们携手 专业进步 你我共荣 (b)(b)(f)(f)(f)