CAJ | 학술논문

1例51岁男性乙型肝炎肝硬化失代偿期患者因上消化道出血给予静脉滴注生长抑素3 mg持续12 h；兰索拉唑30 mg，1次/12 h；维生素K110 mg，1次/d。维生素K1和兰索拉唑于2 h输注完毕，患者未出现不适。生长抑素滴注约2.5 h时，患者出现寒颤，呼吸困难，立即停用生长抑素。约10 min后患者出现神志不清、呼之不应，心率160次/min，呼吸32次/min，血压测不到。予面罩吸氧，地塞米松10 mg静脉注射，肾上腺素1 mg皮下注射，异丙嗪25 mg肌内注射。约20 min后，患者逐渐清醒，但精神萎靡，表情淡漠。1.5 h 后，寒颤、呼吸困难消失，复查心率110次/min，呼吸23次/min，血压109/50 mmHg（1 mmHg＝0.133 kPa）。换用醋酸奥曲肽0.5 mg溶于0.9%氯化钠注射液60 ml，1次/12 h静脉泵入，兰索拉唑、维生素K1继续治疗，患者未再发生类似症状。
1례51세남성을형간염간경화실대상기환자인상소화도출혈급여정맥적주생장억소3 mg지속12 h；란색랍서30 mg，1차/12 h；유생소K110 mg，1차/d。유생소K1화란색랍서우2 h수주완필，환자미출현불괄。생장억소적주약2.5 h시，환자출현한전，호흡곤난，립즉정용생장억소。약10 min후환자출현신지불청、호지불응，심솔160차/min，호흡32차/min，혈압측불도。여면조흡양，지새미송10 mg정맥주사，신상선소1 mg피하주사，이병진25 mg기내주사。약20 min후，환자축점청성，단정신위미，표정담막。1.5 h 후，한전、호흡곤난소실，복사심솔110차/min，호흡23차/min，혈압109/50 mmHg（1 mmHg＝0.133 kPa）。환용작산오곡태0.5 mg용우0.9%록화납주사액60 ml，1차/12 h정맥빙입，란색랍서、유생소K1계속치료，환자미재발생유사증상。
A 51-year-old male hepatitis B patient with decompensated liver cirrhosis received IV infusions of somatostatin 3 mg for continuous 12 hours,lansoprazole 30 mg every 12 hours,vitamin K1 10 mg once daily due to upper gastrointestinal hemorrhage. The IV infusions of vitamin K1 and lansoprazole were completed within 2 hours and the patient did not present discomfort symptoms. About 2. 5 hours after the IV infusion of somatostatin,the patient developed chills and dyspnea. Somatostatin was withdrawn immediately. About 10 minutes later,he lost consciousness and had no response to voice stimuli. His heart rate was 160 times/min,respiratory rate was 32 breaths/min,and blood pressure undetectable. He was treated with oxygen mask. Intravenous dexamethasone 10 mg, subcutaneous injection of epinephrine 1 mg and intramuscular injection of promethazine 25 mg were given. About 20 minutes later,the patient slowly began to regain consciousness,but still had listlessness and apathy. His symptoms such as chills and dyspnea disappeared 1. 5 hours later,and then his heart rate was 110 times/min,respiratory rate was 23 breaths/min,and blood pressure was 109/50 mmHg. His therapy was changed to octreotide acetate 0. 5 mg in 0. 9%sodium chloride injection 60 ml every 12 hours via IV pump,lansoprazole and vitamin K1 were continued, the similar symptoms did not recur.