CAJ | 학술논문

目的：分析手术引起的严重过敏反应患者的临床特点。方法回顾性分析1990年至今发生严重过敏反应将患者的临床特点。结果患者平均年龄39±16岁，男∶女＝1∶2．2；发作时收缩压及舒张压均较基础血压明显下降（P ＜0．01），发作心率较基础心率明显增加（P ＜0．01）；手术组发生严重过敏反应的患者与非手术组相比，女性患者更常见（P ＜0．01）；2008年后手术组患者较非手术组患者有明显增加（P ＜0．01）；手术组患者的基础疾病多为肿瘤（10/14），以妇产科手术居首（10/14），而非手术组患者的基础疾病多表现为变态反应性疾病（9/28）；手术组患者病因最常见为抗生素（8/14），其次为麻醉剂（5/14），非手术组患者最常见病因同样为抗生素（6/28），其次为造影剂（4/28）和食物（4/28）；手术组和非手术组患者发作血压均较基础血压明显下降（P ＜0．01），非手术组更易出现血压下降为0（9/12）；严重过敏反应最常见的临床表现为皮肤黏膜症状，手术组患者更易出现意识丧失（P ＜0．01）；手术组患者白细胞升高较非手术组更加明显（P ＜0．05）；与手术组患者相比，非手术组患者更易危及生命（3/28）。结论严重过敏反应最常见的临床表现为皮肤黏膜症状。手术组发生严重过敏反应的患者与非手术组相比，女性患者更常见，基础疾病多为肿瘤，以妇产科手术居首，病因常为抗生素和麻醉剂，更易出现意识丧失，白细胞升高更加明显，2008年后有明显增加的趋势；非手术组患者的基础疾病多表现为变态反应性疾病，常见病因为抗生素、造影剂和食物，血压更易下降为0，易危及生命。
목적：분석수술인기적엄중과민반응환자적림상특점。방법회고성분석1990년지금발생엄중과민반응장환자적림상특점。결과환자평균년령39±16세，남∶녀＝1∶2．2；발작시수축압급서장압균교기출혈압명현하강（P ＜0．01），발작심솔교기출심솔명현증가（P ＜0．01）；수술조발생엄중과민반응적환자여비수술조상비，녀성환자경상견（P ＜0．01）；2008년후수술조환자교비수술조환자유명현증가（P ＜0．01）；수술조환자적기출질병다위종류（10/14），이부산과수술거수（10/14），이비수술조환자적기출질병다표현위변태반응성질병（9/28）；수술조환자병인최상견위항생소（8/14），기차위마취제（5/14），비수술조환자최상견병인동양위항생소（6/28），기차위조영제（4/28）화식물（4/28）；수술조화비수술조환자발작혈압균교기출혈압명현하강（P ＜0．01），비수술조경역출현혈압하강위0（9/12）；엄중과민반응최상견적림상표현위피부점막증상，수술조환자경역출현의식상실（P ＜0．01）；수술조환자백세포승고교비수술조경가명현（P ＜0．05）；여수술조환자상비，비수술조환자경역위급생명（3/28）。결론엄중과민반응최상견적림상표현위피부점막증상。수술조발생엄중과민반응적환자여비수술조상비，녀성환자경상견，기출질병다위종류，이부산과수술거수，병인상위항생소화마취제，경역출현의식상실，백세포승고경가명현，2008년후유명현증가적추세；비수술조환자적기출질병다표현위변태반응성질병，상견병인위항생소、조영제화식물，혈압경역하강위0，역위급생명。
Objective To analyze the clinical characteristics of patients with perioperative anaphylaxis,and compared with the non-operative patients.Methods We analyzed the condi-tion,age characteristic,underlying diseases,operation,cause,change of blood pressure,clinical manifestation,level of white blood cell,and prognosis of patients with anaphylaxis from 1990 retro-spectively.Results The mean age was 39±16 years old.The ratio of Male and female was 1:2.2. Dropping in systolic and diastolic blood pressure(P <0.01)and increase in heart rate(P <0.01) were notable.Compared with non-operative patients,among the perioperative patients female pa-tients were more common(P <0.01),the number of patients increased obviously after 2008,the majority underlying disease and operation were tumor(10 /14)and gynecology and obstetrics(10 /14),the common cause was antibiotics(8 /14)and anesthetic(5 /14),and the patients were prone to loss of consciousness(P <0.01).However among the non-operative patients allergic diseases(9 /28)were the majority underlying disease,the common cause was antibiotics(6 /28),contrast medi-um(4 /28)and food(4 /28),blood pressure was prone to drop to 0(9 /12),white blood cell in-creased obviously(P <0.05)and life-threatening was common(3 /28).Conclusion Compared with non-operative patients,female patients were more common,the number of patients increased obviously after 2008,the majority underlying disease and operation were tumor and gynecology and obstetrics,the common cause was antibiotics and anesthetic,and the patients were prone to loss of consciousness among the perioperative patients.