1例尖吻蝮蛇血凝酶致过敏性休克的护理体会.docVIP

精品论文 参考文献 1例尖吻蝮蛇血凝酶致过敏性休克的护理体会 余雪红1 王红玉2 　　【摘 要】 目的 总结尖吻蝮蛇血凝酶致过敏性休克的急救护理和防范措施。方法 我院收治1例输尿管结石伴感染的68岁女性患者，行输尿管镜下钬激光碎石+输尿管支架管置入术,术后苏醒安返病房，留置尿管中尿液呈鲜红色，给予静脉注射尖吻蝮蛇血凝酶1 U，10 分钟后患者出现过敏性休克，立即实施人工通气、胸外心脏按压、抗过敏、抗休克等急救治疗和精心护理。结果 患者生命体征恢复平稳，无并发症发生，治愈出院。结论 密切观察患者病情变化，及时发现危机状况并快速有效地进行干预，是抢救成功的关键。 　　【关键词】 尖吻蝮蛇血凝酶； 过敏性休克； 急救护理； 防范措施 　　Case report： Anaphylactic Shock Induced by Haemocoagulase Agkistrodon （HCA） in Nursing Experience 　　Yu Xuehong ,Wang Hongyu ICU and Department of Science and Education of Wenjiang District Peoples Hospital of ChengDu City, ChengDu 611130, Sichuan Province ,P.R.China. 　　【Abstract】 Objective To summarize the emergency nursing and preventive measures of anaphylactic shock induced by HCA. Methods one 68-year-old woman was admitted owing to ureteral calculi accompanied by infection, executing holmium laser lithotripsy under ureter mirror+ureteral stent implantation surgery, postoperative recoveried back to the wards, and the urine of indwelling urinary catheter was in bright red. She was intravenously given HCA 1 U, and anaphylactic shock occurred after 10 minutes. She was given immediately the artificial ventilation, chest compressions, anti-allergic, anti-shock etc. emergency treatment and careful nursing. Results the vital signs of the patient recovered smoothly, with no complications, cured and discharged. Conclusion Observation of the changes in the patients condition closely, we find that discovering the crisis situation and carrying out the intervention quickly and efficiently is the key to successful treatment. 　　【Key words】 Haemocoagulase agkistrodon, HCA; Anaphylactic shock; Emergency nursing; Preventive measures. 　　注射用尖吻蝮蛇血凝酶（haemocoagulase agkistrodon，HCA）是利用我国特有的蛇种—尖吻蝮蛇体内的毒液研制出的新一代临床止血药，是迄今为止我国上市产品中唯一完成全部氨基酸测序的单一组分的蛇毒血凝酶类药物[1]，止血疗效好且安全性高[2-3]，可以减少手术后创面出血量及术后引流量[4]、缩短止血时间[4-5]，并且起效快、药效持久、不引起血管内栓塞[6]。有文献报道[7]，尖吻蝮蛇血凝酶可降低腹部手术术中出血量和术后引流量，对腹部手术围手术期应用可靠安全。但近年来，随着该药临床应用日益广泛，据相关文献报道[8-10]，其不良反应报道日趋增多，而临床医务工作者对该新药产生的药物不良反应未引起足够重视。过敏性