一例患者经颈静脉肝内门体分流术术中碘克沙醇致过敏性休克后顺利完成手术及文献分析

doi:10.5246/jcps.2023.08.056

中国药学(英文版) ›› 2023, Vol. 32 ›› Issue (8): 677-682.DOI: 10.5246/jcps.2023.08.056

一例患者经颈静脉肝内门体分流术术中碘克沙醇致过敏性休克后顺利完成手术及文献分析

解伟伟, 刘剑, 张玉倩, 张志清, 靳怡然^*()

河北医科大学第二医院药学部, 河北石家庄 050000

收稿日期:2023-03-19 修回日期:2023-04-24 接受日期:2023-05-14 出版日期:2023-08-31 发布日期:2023-08-31
通讯作者: 靳怡然
作者简介:
+ Tel.: +86-311-86265625; Fax: +86-311-86266419; E-mail: jinyiran@sohu.com

A case of anaphylactic shock caused by iodixanol during transjugular intrahepatic portosystemic shunt and literature analysis

Weiwei Xie, Jian Liu, Yuqian Zhang, Zhiqing Zhang, Yiran Jin^*()

The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China

Received:2023-03-19 Revised:2023-04-24 Accepted:2023-05-14 Online:2023-08-31 Published:2023-08-31
Contact: Yiran Jin

摘要/Abstract

摘要：

河北医科大学第二医院消化内科收治一例68岁患者, 局部麻醉下行经颈静脉肝内门体分流术(transjugular intrahepatic portosystem shunt, TIPS), 使用碘克沙醇注射液高压造影, 15分钟后患者出现血压下降、皮肤瘙痒等症状, 考虑患者出现过敏性休克, 立即给予抗过敏、抗休克等急救治疗措施。患者生命体征指标逐渐恢复, 过敏性休克症状逐渐消失, 手术继续且顺利完成, 无并发症发生。现就此例经颈静脉肝内门体分流术术中碘克沙醇注射液致过敏性休克患者的抢救措施及治疗情况进行分析, 旨在加强临床安全使用碘克沙醇的用药意识。当患者使用碘克沙醇注射液造影时, 短时间内出现血压下降, 皮肤瘙痒等问题时, 可能发生了过敏性休克。术中应严密观察患者的病情, 及时发现过敏症状并及时进行有效处理, 是抢救过敏性休克的关键。

关键词: 经颈静脉肝内门体分流术, 碘克沙醇注射液, 过敏性休克, 抢救措施

Abstract:

A 68-year-old patient was admitted to the Department of Gastroenterology at the Second Hospital of Hebei Medical University and underwent a transjugular intrahepatic portosystemic shunt (TIPS) under local anesthesia using iodixanol injection for high pressure imaging. After 15 min, the patient developed symptoms, such as a drop in blood pressure and skin itching, indicating anaphylactic shock. We promptly administered emergency measures, including antiallergic and anti-shock treatment. The patient’s vital signs gradually recovered, and the symptoms of anaphylactic shock disappeared. Ultimately, the operation was successfully completed without any complications. This article analyzed the rescue measures and treatment of a patient who experienced anaphylactic shock due to an iodixanol injection during TIPS. The purpose was to increase awareness of the safe use of iodixanol. When iodixanol is used for contrast, a patient may experience a drop in blood pressure and skin itching within a short period of time, potentially leading to anaphylactic shock. During the operation, it is crucial to closely monitor the patient’s condition and promptly recognize allergic symptoms for effective treatment. This is the key to rescuing a patient experiencing anaphylactic shock.

Key words: Transjugular intrahepatic portosystemic shunt, Iodixanol injection, Anaphylactic shock, Rescue measures

Supporting:

解伟伟, 刘剑, 张玉倩, 张志清, 靳怡然. 一例患者经颈静脉肝内门体分流术术中碘克沙醇致过敏性休克后顺利完成手术及文献分析[J]. 中国药学(英文版), 2023, 32(8): 677-682.

Weiwei Xie, Jian Liu, Yuqian Zhang, Zhiqing Zhang, Yiran Jin. A case of anaphylactic shock caused by iodixanol during transjugular intrahepatic portosystemic shunt and literature analysis[J]. Journal of Chinese Pharmaceutical Sciences, 2023, 32(8): 677-682.

参考文献 26

[1]	Wang, L.J. Nursing experience of a case of lidocaine anaphylactic shock. Nurs. Discuss. 2017, 18, 0175.
[2]	Zhang, H.; Lei, Z.B. Analysis of domestic literature on 51 cases of death caused by lidocaine injection. Med. Herald. 2017, 36, 1438–1441.
[3]	Yang, L.; Chen, X.M.; Tong, X.H. Anaphylactic shock caused by lidocaine local anesthesia. People’s Mil. Med. 2017, 05, 74–76.
[4]	Zhu, Z.X.; Yang, J.; Dai, Y.Y. Literature analysis of 191 cases of anaphylactic shock caused by lidocaine. China Pharm. 2021, 03, 01–08.
[5]	Shen, X.H.; Luo, L.F.; Lin, Q. Literature analysis of 445 cases of adverse reactions of lidocaine injection. Strait Pharm. J. 2019, 031, 247–249.
[6]	Liu, S.H.; Lan, Y.; Wang, Y.L. Anaphylactic shock caused by lidocaine hydrochloride injection. China Pharm. 2020, 17, 794–797.
[7]	Katayama, H.; Yamaguchi, K.; Kozuka, T.; Takashima, T.; Seez, P.; Matsuura, K. Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1990, 175, 621–628.
[8]	Luo, L.; Ge, L.Q. A case of anaphylactic shock caused by iodixanol during PCI. Modern Med. Health. 2020, 36, 3183–3184.
[9]	Gu, H.W.; Liu, Y.; Sang, J.X. A case of anaphylactic shock caused by iodixanol injection. J. Clin. Med. Literat. 2016, 03, 584.
[10]	Zhang, X.P. Cause analysis and countermeasures of cardiac arrest caused by delayed allergic reaction of iodixanol injection. Chin. J. Dig. Dis. Image. 2014, 002, 88–90.
[11]	Duan, D.D.; Ma, C.L. A case of severe allergic reaction caused by iodixanol injection. China Pharm. 2012, 11, 704.
[12]	Li, X.; Liu, H.; Zhao, L.; Liu, J.L.; Cai, L.; Liu, L.; Zhang, W.G. Clinical observation of adverse drug reactions to non-ionic iodinated contrast media in population with underlying diseases and risk factors. Br. J. Radiol. 2017, 90, 20160729.
[13]	Rosado Ingelmo, A.; Doña Diaz, I.; Cabañas Moreno, R.; Moya Quesada, M.C.; García-Avilés, C.; García Nuñez, I.; Martínez Tadeo, J.I.; Mielgo Ballesteros, R.; Ortega-Rodríguez, N.; Padial Vilchez, M.A.; Sánchez-Morillas, L.; Vila Albelda, C.; Moreno Rodilla, E.; Torres Jaén, M.J. Clinical practice guidelines for diagnosis and management of hypersensitivity reactions to contrast media. J. Investig. Allergol. Clin. Immunol. 2016, 26, 144–155.
[14]	Böhm, I.; Morelli, J.; Nairz, K.; Silva Hasembank Keller, P.; Heverhagen, J.T. Myths and misconceptions concerning contrast media-induced anaphylaxis: a narrative review. Postgrad Med. 2017, 129, 259–266.
[15]	Sohn, K.H.; Kim, G.W.; Lee, S.Y.; Kim, H.S.; Cho, S.H.; Han, J.K.; Kang, H.R. Immediate and delayed hypersensitivity after intra-arterial injection of iodinated contrast media: a prospective study in patients with coronary angiography. Eur. Radiol. 2019, 29, 5314–5321.
[16]	Nayak, K.R.; White, A.A.; Cavendish, J.J.; Barker, C.M.; Kandzari, D.E. Anaphylactoid reactions to radiocontrast agents: prevention and treatment in the cardiac catheterization laboratory. J. Invasive Cardiol. 2009, 21, 548–551.
[17]	Li, X.D.; Yang, Y.J.; Gao, L.J. A case of coronary artery complicated with slow blood flow, branch occlusion, stent thrombosis and anaphylactic shock after percutaneous coronary intervention. China Circ. J. 2016, 031, 1001.
[18]	Ma, J.F. Analysis of shock caused by contrast agent Iohexol injection. China Pharm. 2009, 12, 1287–1288.
[19]	Zhuang, W.; Wu, Y.J.; Liu, Y.Q. Characteristics and rescue experience of anaphylactic shock caused by iodine contrast agent during coronary intervention. China Circ. J. 2013, 28, 262–265.
[20]	Huang, X.; Guo, D.; Chen, C. Analysis of adverse reactions and clinical application of iodine contrast media. China Pharm. 2007, 10, 869–870.
[21]	Wan, Z.G.; Li, Y.N. Literature analysis of 108 cases of anaphylactic shock caused by iodine contrast media. China Pharm. 2009, 12, 1309–1310.
[22]	Chen, Y.D.; Chen, J.Y.; Fu, G.S. China Expert Consensus on Adverse Reactions Related to the Application of Iodine Contrast Angiography. China J. Int. Cardiol. 2014, 22, 341–348.
[23]	Working Group on the Safe Use of Contrast Agents of Radiology Branch of Chinese Medical Association. Guidelines for the Use of Contrast Agents. Chin. Med. J. 2014, 93, 376–379.
[24]	Al-Ahmad, M.; Bouza, T.R. Successful desensitization to radiocontrast media in two high-risk cardiac patients. Ann. Saudi Med. 2017, 37, 333–335.
[25]	Yamaguchi, K.; Katayama, H.; Takashima, T.; Kozuka, T.; Seez, P.; Matsuura, K. Prediction of severe adverse reactions to ionic and nonionic contrast media in Japan: evaluation of pretesting. A report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1991, 178, 363–367.
[26]	Macy, E.M. Current epidemiology and management of radiocontrast-associated acute- and delayed-onset hypersensitivity: a review of the literature. Perm. J. 2018, 22, 17–072.

一例患者经颈静脉肝内门体分流术术中碘克沙醇致过敏性休克后顺利完成手术及文献分析

A case of anaphylactic shock caused by iodixanol during transjugular intrahepatic portosystemic shunt and literature analysis

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