抢救过敏性休克的药物有哪些 徐娟 徐州矿务集团总医院
过敏性休克抢救药物有：1、首选肾上腺素立即皮下注射0.1%盐酸肾上腺素0.5～1ml，病儿酌减，如如症状不缓解，可每隔半小时皮下或静脉注射0.5ml，直至脱离险期，此药是抢救过敏性休克的首选药物，它具有收缩血管、增加外周阻力、兴奋心肌、增加心输量及松弛支气管平滑肌的作用。0.1%肾上腺素能通过兴奋β受使支气管痉挛快速舒张，通过α受体效应使外周小血管收缩，还能对抗部分I型变态反应的介质释放。是救治过敏性休克的首选药物，先给0.1%肾上腺素0.5-1ml肌肉注射，如症状不缓解，可每隔半小时皮下或静脉注射0.5ml，直至脱离险期10分钟后重复应用，在病程中可重复应用数次，直至脱离险期。2、抗过敏：静脉注射地塞米松10～20mg，氢化考的松200～400mg。3、补充血容量，首选补入平衡液500ml快速滴入，然后给与5%的葡萄糖。4、沙丁胺醇扩张支气管，吸入肾上腺素治疗哮喘。抗过敏及其对症处理。5、抗组胺药物：常用的是苯海拉明或盐酸异丙嗪。6、呼吸抑制时要进行呼吸兴奋剂应用。过程中监测生命体征，最少观察24小时，临床表现严重需住院治疗。绝大多数的过敏性休克属Ⅰ型变态反应。外界的抗原性物质(某些药物是不全抗原，进入人体后与蛋白质结合成为全抗原)进入体内能刺激免疫系统产生相应的IgE抗体，其中IgE的产量因体质不同而有较大差异。这些特异性IgE有较强的亲细胞特质，能与皮肤、支气管、血管壁等的“靶细胞”结合。此后当同一抗原物质再次与已致敏的机体接触时，就能激发广泛的Ⅰ型变态反应，其中各种炎性细胞释放的组胺、血小板激活因子等是造成组织器官水肿、渗出的主要生物活性物质。糖皮质激素，疗程不超过3～5日，或地塞米松，以5%葡萄糖注射液稀释后静滴，一般用药1～3日。
What are the drugs to rescue anaphylactic shock
The first choice for the treatment of anaphylactic shock is to inject 0.1% epinephrine hydrochloride subcutaneously immediately, The number of sick children decreased, If the symptoms are not relieved, 0.5ml can be injected subcutaneously or intravenously every half an hour, Up to the period of exit, This drug is the first choice to rescue anaphylactic shock, It can constrict blood vessels, increase peripheral resistance, excite myocardium, increase cardiac output and relax bronchial smooth muscle. 0.1% adrenaline can relax bronchospasm rapidly through β stimulation, Through the α receptor effect, the peripheral small blood vessels contract, It can also resist the release of some media of type I allergy. It is the first choice for the treatment of anaphylactic shock, First, 0.5-1ml of 0.1% adrenaline was injected intramuscularly, If the symptoms are not relieved, 0.5ml can be injected subcutaneously or intravenously every half an hour, Repeat the application until 10 minutes after the insurance period, It can be repeated several times in the course of the disease, Up to the period of exit. 2. Anti allergy: intravenous dexamethasone 10-20mg, Hydrocortisone 200-400mg. 3. Replenish blood volume, It is preferred to add 500ml of balance liquid for rapid dripping, Then give 5% glucose. 4. Salbutamol dilates the bronchi, Inhale adrenaline to treat asthma. Anti allergy and its treatment. 5. Antihistamines: diphenhydramine or promethazine hydrochloride are commonly used. 6. Respiratory stimulants should be used in respiratory depression. Monitor vital signs during the process, Observe for at least 24 hours, Serious clinical manifestations need hospitalization. Most of anaphylactic shock belongs to type I allergy. External antigenic substances (some drugs are incomplete antigens, After entering the human body, it combines with protein to form a whole antigen) entering the body can stimulate the immune system to produce corresponding IgE antibodies, The yield of IgE is different with different constitution. These specific IGES have strong cytophilic properties, It can be combined with target cells of skin, bronchus, vascular wall, etc. After that, when the same antigen substance contacts the sensitized body again, It can trigger a wide range of type I allergic reactions, Histamine and platelet activating factor released by various inflammatory cells are the main bioactive substances that cause edema and exudation of tissues and organs. Glucocorticoids, The course of treatment should not exceed 3-5 days, Or dexamethasone, Diluted with 5% glucose injection, intravenous drip, The general medication lasted for 1-3 days.
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