高级检索
药物不良反应杂志
期刊首页
过刊列表
高级检索
稿件发表
• 指南与共识 •
ENGLISH ABSTRACT
《严重过敏反应急救指南》推荐意见
李晓桐
翟所迪
王强
王育琴
尹佳
陈玉国
陈荣昌
张洪君
杨克虎
李天佐
郑亚安
马青变
刘芳
崔畅
郑航慈
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1008-5734.2019.02.002
Recommendations in Guideline for Emergency Management of Anaphylaxis
Li Xiaotong
Zhai Suodi
Wang Qiang
Wang Yuqin
Yin Jia
Chen Yuguo
Chen Rongchang
Zhang Hongjun
Yang Kehu
Li Tianzuo
Zheng Ya′an
Ma Qingbian
Liu Fang
Cui Chang
Zheng Hangci
Authors Info & Affiliations
Li Xiaotong
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; Institute for Drug evaluation, Peking University Health Science Center, Beijing 100191, China; Department of Pharmacy Administration and Clinical Pharmacy, Peking University School of Pharmaceutical Sciences, Beijing 100191, China
Zhai Suodi
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; Institute for Drug evaluation, Peking University Health Science Center, Beijing 100191, China
Wang Qiang
National Center for Medical Service Administration, National Health Commission of the People′s Republic of China, Beijing 100190, China
Wang Yuqin
Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Yin Jia
Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100005, China
Chen Yuguo
Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan 250012, China
Chen Rongchang
Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
Zhang Hongjun
Department of Nursing, Peking University Third Hospital, Beijing 100191, China
Yang Kehu
Evidence-based Medicine Center, Lanzhou University, Lanzhou 730000, China
Li Tianzuo
Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Zheng Ya′an
Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
Ma Qingbian
Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
Liu Fang
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; Institute for Drug evaluation, Peking University Health Science Center, Beijing 100191, China
Cui Chang
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; Institute for Drug evaluation, Peking University Health Science Center, Beijing 100191, China; Department of Pharmacy Administration and Clinical Pharmacy, Peking University School of Pharmaceutical Sciences, Beijing 100191, China
Zheng Hangci
Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; Institute for Drug evaluation, Peking University Health Science Center, Beijing 100191, China; Department of Pharmacy Administration and Clinical Pharmacy, Peking University School of Pharmaceutical Sciences, Beijing 100191, China
·
DOI： 10.3760/cma.j.issn.1008-5734.2019.02.002
0
0
0
0
0
0
PDF下载
APP内阅读
摘要

《严重过敏反应急救指南》的推荐意见围绕严重过敏反应的诊断、救治准备、救治措施和救治后管理回答了15个临床问题，共形成26条推荐意见。推荐意见中的证据质量分为高、中、低和极低4级，推荐强度分为强、弱2级。推荐意见的强度主要基于对利弊的权衡，不完全依赖于证据质量。临床严重过敏反应的急救可参照推荐意见实施。

指南;过敏反应;休克;急救医学;循证医学;肾上腺素;糖皮质激素类
ABSTRACT

The recommendations of Guideline for Emergency Management of Anaphylaxis answered 15 clinical questions about diagnosis, preparation for treatment, treatment measures, and post-treatment management of anaphylaxis and a total of 26 recommendations were formed. In the recommendations, the quality of evidence was divided into 4 levels: high, moderate, low, and very low. And the strength of recommendation was divided into 2 levels: strong and weak. The strength of recommendations was mainly determined by weighing the advantages and disadvantages, instead of relying on the quality of evidence. Emergency management of anaphylaxis in clinical practice could be carried out with reference to the recommendations of this guideline.

Guideline;Anaphylaxis;Shock;Emergency medicine;Evidence-based medicine;Epinephrine;Glucocorticoids
Zhai Suodi, Email: mocdef.3ab61idousiahz
Copyright by Chinese Medical Association
No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.
All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.
引用本文

李晓桐,翟所迪,王强,等. 《严重过敏反应急救指南》推荐意见[J]. 药物不良反应杂志,2019,21(2)：85-91.

DOI:10.3760/cma.j.issn.1008-5734.2019.02.002

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

编者按
严重过敏反应是指机体在接触过敏原后突发的、严重的、可危及生命的全身性过敏反应，诊断不及时、救治不当可导致严重后果。《严重过敏反应急救指南》是在国家卫生健康委员会医疗管理服务指导中心的指导下，由多个相关学会和机构合作制订的循证指南。在该指南全文正式发布前，本刊先行刊出该指南关于严重过敏反应诊断、救治和救治后管理的26条推荐意见，以使临床尽快得到关于严重过敏反应急救的指导，同时征求对该指南的反馈意见。
严重过敏反应是指机体在接触过敏原后突发的、严重的、可危及生命的全身性过敏反应 [ 1 ]。其主要临床特征为快速出现威胁生命的呼吸系统或/和循环系统问题，大部分情况下会出现皮肤黏膜系统症状 [ 2 ]。严重过敏反应通常在患者接触过敏原后数分钟至数小时内发作 [ 1 ]。部分患者(0.4%～23.3%)会发生双相反应，即患者初次发作的症状缓解后，在未接触过敏原的情况下严重过敏反应的症状再次发作 [ 3 , 4 , 5 ]；双相反应的发作间隔时间范围为数分钟至数天 [ 4 ]。还有小部分患者会发生迟发性严重过敏反应，即在接触过敏原后数小时至数天内发作 [ 6 , 7 , 8 ]。
我国对严重过敏反应的认识尚存在不足，缺少统一的诊断标准和救治规范，临床救治措施有许多不合理之处 [ 9 , 10 ]，亟需科学、合理的指导。因此，在国家卫生健康委员会医疗管理服务指导中心的指导下，由中国药理学会药源性疾病学专业委员会、中国医师协会变态反应医师分会、中华医学会变态反应学分会、中华医学会急诊医学分会、中华医学会呼吸病学分会、中华医学会麻醉医学分会、中国药学会医院药学专业委员会和中华护理学会联合发起《严重过敏反应急救指南》制订，由北京大学第三医院药剂科负责进行相关调研、制作循证证据并起草指南，兰州大学循证医学中心提供技术支持。根据美国医学科学院制定的临床实践指南定义 [ 11 ]和2014年发布的《世界卫生组织指南制订手册》中关于指南的制订流程以及相关方法学标准 [ 12 ]，指南的制订流程包括指南项目组筹建、指南注册与撰写计划书、临床问题和结局指标的收集与遴选、开题会确定临床问题与结局指标排序、证据的制作与形成、推荐意见的起草、专家共识形成推荐意见、推荐意见的外审与修订、指南全文的撰写与发布、指南的传播与实施、指南的评价及更新等。
本指南采用推荐分级的评估、制定与评价标准(Grades of Recommendations Assessment, Development and Evaluation，GRADE)系统评价原始证据，将证据质量分为高(A)、中(B)、低(C)和极低(D)4级，将推荐强度分为强(1)、弱(2)2级( 表1 ) [ 13 , 14 ]。在使用指南研究与评价工具(Appraisal of Guidelines for Research and Evaluation, AGREE Ⅱ) [ 15 ]评价其他指南 [ 2 , 3 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]的基础上，本指南项目组专家基于现有最佳证据与经验形成推荐意见；推荐意见的强度主要基于对利弊的权衡，不完全依赖于证据质量 [ 13 ]。
分级 具体描述 研究类型
证据质量    
  高质量(A) 非常确信真实的效应值接近效应估计值 1.设计优良的随机对照试验
  2.质量升高2级的观察性研究
  中等质量(B) 对估计效应值有中等程度的信心：真实效应值可能与估计效应值相近，　不排除大不相同的可能 1.质量降低1级的随机对照试验
  2.质量升高1级的观察性研究
  低质量(C) 对估计效应值的信任程度有限：真实效应值可能与估计效应值大不相同 1.质量降低2级的随机对照试验
  2.观察性研究
  极低质量(D) 对估计效应值几乎没有信心，真实效应值很可能与估计效应值大不相同 1.质量降低3级的随机对照试验
  2.质量降低1级的观察性研究
  3.病例序列报告
  4.个案报道
推荐强度    
  强(1) 遵从推荐意见利大于弊
  弱(2) 遵从推荐意见时利弊不确定或利弊相当(证据质量、意愿和价值观等方面可能存在较大不确定性)
推荐分级的评估、制定与评价标准中关于证据质量等级与推荐强度的描述
Description about quality of evidence and strength of recommendations in Grades of Recommendations Assessment, Development and Evaluation
完整的指南包括前言、制订方法与正文3部分，正文包括推荐意见、证据总结、推荐说明等内容。推荐意见部分由围绕严重过敏反应的诊断、救治准备、救治措施和救治后管理等方面的26条推荐意见组成。现先行发表该指南的26条推荐意见，全文及相关资料以后将在其他刊物上发表。
参考文献
[1]
Sampson HA , Muñoz-Furlong A , Campbell RL ,et al. Second symposium on the definition and management of anaphylaxis: summary report--second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium[J]. Ann Emerg Med, 2006,47(4):373-380. DOI: 10.1016/j.annemergmed.2006.01.018 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Soar J , Pumphrey R , Cant A ,et al. Emergency treatment of anaphylactic reactions--guidelines for healthcare providers[J]. Resuscitation, 2008,77(2):157-169. DOI: 10.1016/j.resuscitation.2008.02.001 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Simons FE , Ardusso LR , Bilò MB ,et al. World allergy organization guidelines for the assessment and management of anaphylaxis[J]. World Allergy Organ J, 2011,4(2):13-37. DOI: 10.1097/WOX.0b013e318211496c .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Lee S , Bellolio MF , Hess EP ,et al. Time of onset and predictors of biphasic anaphylactic reactions: a systematic review and meta-analysis[J]. J Allergy Clin Immunol Pract, 2015,3(3):408-416. DOI: 10.1016/j.jaip.2014.12.010 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Tole JW , Lieberman P . Biphasic anaphylaxis: review of incidence, clinical predictors, and observation recommendations[J]. Immunol Allergy Clin North Am, 2007,27(2):309-326. DOI: 10.1016/j.iac.2007.03.011 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Limb SL , Starke PR , Lee CE ,et al. Delayed onset and protracted progression of anaphylaxis after omalizumab administration in patients with asthma[J]. J Allergy Clin Immunol, 2007,120(6):1378-1381. DOI: 10.1016/j.jaci.2007.09.022 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Vinuya R Z , Simon M R , Schwartz L B . Elevated serum tryptase levels in a patient with protracted anaphylaxis[J]. Ann allergy, 1994,73(3):232-234.
返回引文位置Google Scholar
百度学术
万方数据
[8]
Zisa G , Riccobono F , Calamari A M ,et al. A case of protracted hypotension as unique symptom of a biphasic anaphylaxis to amoxicillin[J]. Eur Ann Allergy Clin Immunol, 2009,41(2):60.
返回引文位置Google Scholar
百度学术
万方数据
[9]
Jiang N , Yin J , Wen L ,et al. Characteristics of anaphylaxis in 907 Chinese patients referred to a tertiary allergy center: a retrospective study of 1，952 episodes[J]. Allergy Asthma Immunol Res, 2016,8(4):353-361. DOI: 10.4168/aair.2016.8.4.353 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Wang T , Ma X , Xing Y ,et al. Use of Epinephrine in patients with drug-induced anaphylaxis: an analysis of the Beijing Pharmacovigilance Database[J]. Int Arch Allergy Immunol, 2017，173(1):51-60. DOI: 10.1159/000475498 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Graham R , Mancher M , Wolman DM ,et al. Clinical practice guidelines we can trust[M]. Washington (DC):National Academies Press (US), 2011.
返回引文位置
[12]
WHO handbook for guideline development－2nd edition[EB/OL]. ( 2014) [2018-06-30]. http://apps.who.int/medicinedocs/en/m/abstract/Js22083en/.
返回引文位置Google Scholar
百度学术
万方数据
[13]
Guyatt G H , Oxman A D , Kunz R ,et al. Going from evidence to recommendations[J]. BMJ, 2008,336(7652):1049-1051. DOI: 10.1136/bmj.39493.646875.AE .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Balshem H , Helfand M , Schünemann H J ,et al. GRADE guidelines: 3. Rating the quality of evidence[J]. J clin epidemiol, 2011,64(4):401-406. DOI: 10.1016/j.jclinepi.2010.07.015 doi: .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Brouwers MC , Kho ME , Browman GP ,et al. AGREE II: advancing guideline development, reporting and evaluation in health care[J]. J Clin Epidemiol, 2010,63(12):1308-1311. DOI: 10.1016/j.jclinepi.2010.07.001 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Muraro A , Roberts G , Clark A ,et al. The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology[J]. Allergy, 2007,62(8):857-871. DOI: 10.1111/j.1398-9995.2007.01421.x .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Muraro A , Roberts G , Worm M ,et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology[J]. Allergy, 2014,69(8):1026-1045. DOI: 10.1111/all.12437 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Kolawole H , Marshall SD , Crilly H ,et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists perioperative anaphylaxis management guidelines[J]. Anaesth Intensive Care, 2017,45(2):151-158. DOI: 10.1177/0310057X1704500204 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
The diagnosis and management of anaphylaxis: an updated practice parameter[J]. J Allergy Clin Immunol, 2005,115(3Suppl 2):S483-523. DOI: 10.1016/j.jaci.2005.01.010 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Lieberman P , Nicklas RA , Oppenheimer J ,et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update[J]. J Allergy Clin Immunol, 2010,126(3):477-480. DOI: 10.1016/j.jaci.2010.06.022 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Lieberman P , Nicklas RA , Randolph C ,et al. Anaphylaxis--a practice parameter update 2015[J]. Ann Allergy Asthma Immunol, 2015,115(5):341-384. DOI: 10.1016/j.anai.2015.07.019 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Simons FE , Ardusso LR , Dimov V ,et al. World Allergy Organization anaphylaxis guidelines: 2013 update of the evidence base[J]. Int Arch Allergy Immunol, 2013,162(3):193-204. DOI: 10.1159/000354543 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Simons FE , Ebisawa M , Sanchez-Borges M ,et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines[J]. World Allergy Organ J, 2015,8(1):32. DOI: 10.1186/s40413-015-0080-1 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Tse Y , Rylance G . Emergency management of anaphylaxis in children and young people: new guidance from the Resuscitation Council (UK)[J]. Arch Dis Child Educ Pract Ed, 2009,94(4):97-101. DOI: 10.1136/adc.2007.120378 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Ring J , Beyer K , Biedermann T ,et al. Guideline for acute therapy and management of anaphylaxis: S2 Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Association of German Allergologists (AeDA), the Society of Pedi-atric Allergy and Environmental Medicine (GPA), the German Academy of Allergology and Environmental Medicine (DAAU), the German Professional Association of Pediatricians (BVKJ), the Austrian Society for Allergology and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Anaesthesiology and Intensive Care Medicine (DGAI), the German Society of Pharmacology (DGP), the German Society for Psychosomatic Medicine (DGPM), the German Working Group of Anaphylaxis Training and Education (AGATE) and the patient organization German Allergy and Asthma Association (DAAB)[J]. Allergo J Int, 2014,23(3):96-112. DOI: 10.1007/s40629-014-0009-1 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Campbell RL , Li JT , Nicklas RA ,et al. Emergency department diagnosis and treatment of anaphylaxis: a practice parameter[J]. Ann Allergy Asthma Immunol, 2014,113(6):599-608. DOI: 10.1016/j.anai.2014.10.007 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Baumgart K , Brown S , Gold M ,et al. ASCIA guidelines for prevention of food anaphylactic reactions in schools, preschools and child-care centres[J]. J Paediatr Child Health, 2004,40(12):669-671. DOI: 10.1111/j.1440-1754.2004.00509.x .
返回引文位置Google Scholar
百度学术
万方数据
[28]
Vale S , Smith J , Said M ,et al. ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2012 update[J]. J Paediatr Child Health, 2013，49(5):342-345. DOI: 10.1111/jpc.12166 .
返回引文位置Google Scholar
百度学术
万方数据
[29]
Vale S , Smith J , Said M ,et al. ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update[J]. J Paediatr Child Health, 2015,51(10):949-954. DOI: 10.1111/jpc.12962 .
返回引文位置Google Scholar
百度学术
万方数据
[30]
Harper NJ , Dixon T , Dugué P ,et al. Suspected anaphylactic reactions associated with anaesthesia[J]. Anaesthesia, 2009,64(2):199-211. DOI: 10.1111/j.1365-2044.2008.05733.x .
返回引文位置Google Scholar
百度学术
万方数据
[31]
Kroigaard M , Garvey LH , Gillberg L ,et al. Scandinavian clinical practice guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia[J]. Acta Anaesthesiol Scand, 2007,51(6):655-670. DOI: 10.1111/j.1399-6576.2007.01313.x .
返回引文位置Google Scholar
百度学术
万方数据
[32]
Chamberlain D . Emergency medical treatment of anaphylactic reactions. Project Team of the Resuscitation Council (UK)[J]. J Accid Emerg Med, 1999,16(4):243-247. DOI: 10.1007/s11104-011-0885-9 .
返回引文位置Google Scholar
百度学术
万方数据
[33]
Campbell RL , Hagan JB , Manivannan V ,et al. Evaluation of national institute of allergy and infectious diseases/food allergy and anaphylaxis network criteria for the diagnosis of anaphylaxis in emergency department patients[J]. J Allergy Clin Immunol, 2012,129(3):748-752. DOI: 10.1016/j.jaci.2011.09.030 .
返回引文位置Google Scholar
百度学术
万方数据
[34]
Loprinzi BCE , Motosue MS , Li JT ,et al. Prospective validation of the NIAID/FAAN criteria for emergency department diagnosis of anaphylaxis[J]. J Allergy Clin Immunol Pract, 2016，4(6):1220-1226. DOI: 10.1016/j.jaip.2016.06.003 .
返回引文位置Google Scholar
百度学术
万方数据
[35]
Brown SG . Clinical features and severity grading of anaphylaxis[J]. J Allergy Clin Immunol, 2004,114(2):371-376. DOI: 10.1016/j.jaci.2004.04.029 .
返回引文位置Google Scholar
百度学术
万方数据
[36]
Kemp AM , Kemp SF . Pharmacotherapy in refractory anaphylaxis: when intramuscular epinephrine fails[J]. Curr Opin Allergy Clin Immunol, 2014,14(4):371-378. DOI: 10.1097/ACI.0000000000000080 .
返回引文位置Google Scholar
百度学术
万方数据
[37]
Dhami S , Panesar SS , Roberts G ,et al. Management of anaphylaxis: a systematic review[J]. Allergy, 2014,69(2):168-175. DOI: 10.1111/all.12318 .
返回引文位置Google Scholar
百度学术
万方数据
[38]
Fleming JT , Clark S , Camargo CA ,et al. Early treatment of food-induced anaphylaxis with epinephrine is associated with a lower risk of hospitalization[J]. J Allergy Clin Immunol Pract, 2015,3(1):57-62. DOI: 10.1016/j.jaip.2014.07.004 .
返回引文位置Google Scholar
百度学术
万方数据
[39]
Hochstadter E , Clarke A , De Schryver S ,et al. Increasing visits for anaphylaxis and the benefits of early epinephrine administration: a 4-year study at a pediatric emergency department in Montreal, Canada[J]. J Allergy Clin Immunol, 2016,137(6):1888-1890.e4. DOI: 10.1016/j.jaci.2016.02.016 .
返回引文位置Google Scholar
百度学术
万方数据
[40]
Sheikh A , Shehata YA , Brown SG ,et al. Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock[J]. Cochrane Database Syst Rev, 2008, (4):CD006312. DOI: 10.1002/14651858.CD006312.pub2 .
返回引文位置Google Scholar
百度学术
万方数据
[41]
Rubin T , Clayton J , Adams D ,et al. Systematic review of outcome measures in trials of pediatric anaphylaxis treatment[J]. BMC Pediatr, 2014,14:158. DOI: 10.1186/1471-2431-14-158 .
返回引文位置Google Scholar
百度学术
万方数据
[42]
Alqurashi W , Stiell I , Chan K ,et al. Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis[J]. Ann Allergy Asthma Immunol, 2015,115(3):217-223.e2. DOI: 10.1016/j.anai.2015.05.013 .
返回引文位置Google Scholar
百度学术
万方数据
[43]
Ellis AK , Day JH . Incidence and characteristics of biphasic anaphylaxis: a prospective evaluation of 103 patients[J]. Ann Allergy Asthma Immunol, 2007,98(1):64-69. DOI: 10.1016/S1081-1206(10)60861-7 .
返回引文位置Google Scholar
百度学术
万方数据
[44]
Kim TH , Yoon SH , Lee SY ,et al. Biphasic and protracted anaphylaxis to iodinated contrast media[J]. Eur Radiol, 2018,28(3):1242-1252. DOI: 10.1007/s00330-017-5052-0 .
返回引文位置Google Scholar
百度学术
万方数据
[45]
Ko BS , Kim JY , Seo DW ,et al. Should adrenaline be used in patients with hemodynamically stable anaphylaxis? Incident case control study nested within a retrospective cohort study[J]. Sci Rep, 2016,6:20168. DOI: 10.1038/srep20168 .
返回引文位置Google Scholar
百度学术
万方数据
[46]
Lee S , Bellolio MF , Hess EP ,et al. Predictors of biphasic reactions in the emergency department for patients with anaphylaxis[J]. J Allergy Clin Immunol Pract, 2014,2(3):281-287. DOI: 10.1016/j.jaip.2014.01.012 .
返回引文位置Google Scholar
百度学术
万方数据
[47]
Lee S , Peterson A , Lohse CM ,et al. Further evaluation of factors that may predict biphasic reactions in emergency department anaphylaxis patients[J]. J Allergy Clin Immunol Pract, 2017,5(5):1295-1301. DOI: 10.1016/j.jaip.2017.07.020 .
返回引文位置Google Scholar
百度学术
万方数据
[48]
Lertnawapan R , Maek-a-nantawat W . Anaphylaxis and biphasic phase in Thailand: 4-year observation[J]. Allergol Int, 2011,60(3):283-289. DOI: 10.2332/allergolint.10-OA-0256 .
返回引文位置Google Scholar
百度学术
万方数据
[49]
Mehr S , Liew WK , Tey D ,et al. Clinical predictors for biphasic reactions in children presenting with anaphylaxis[J]. Clin Exp Allergy, 2009,39(9):1390-1396. DOI: 10.1111/j.1365-2222.2009.03276.x .
返回引文位置Google Scholar
百度学术
万方数据
[50]
Rohacek M , Edenhofer H , Bircher A ,et al. Biphasic anaphylactic reactions: occurrence and mortality[J]. Allergy, 2014,69(6):791-797. DOI: 10.1111/all.12404 .
返回引文位置Google Scholar
百度学术
万方数据
[51]
Smit DV , Cameron PA , Rainer TH . Anaphylaxis presentations to an emergency department in Hong Kong: incidence and predictors of biphasic reactions[J]. J Emerg Med, 2005,28(4):381-388. DOI: 10.1016/j.jemermed.2004.11.028 .
返回引文位置Google Scholar
百度学术
万方数据
[52]
Sricharoen P , Sittichanbuncha Y , Wibulpolprasert A ,et al. What clinical factors are associated with biphasic anaphylaxis in Thai adult patients？[J]. Asian Pac J Allergy Immunol, 2015,33(1):8-13. DOI: 10.12932/AP0477.33.1.2015 .
返回引文位置Google Scholar
百度学术
万方数据
[53]
Pensrichon R . Comparison of systemic absorption of epinephrine delivered intranasally (5 mg) vs intramuscularly (0.3 mg) using liquid chromatography with tandem mass spectrophotometry (LC-MS/MS)[J]. J Allergy Clin Immunol, 2012,129(2):AB184. DOI: 10.1016/j.jaci.2011.12.254 .
返回引文位置Google Scholar
百度学术
万方数据
[54]
Simons FE , Gu X , Simons KJ . Epinephrine absorption in adults: intramuscular versus subcutaneous injection[J]. J Allergy Clin Immunol, 2001,108(5):871-873. DOI: 10.1067/mai.2001.119409 .
返回引文位置Google Scholar
百度学术
万方数据
[55]
Simons FE , Roberts JR , Gu X ,et al. Epinephrine absorption in children with a history of anaphylaxis[J]. J Allergy Clin Immunol, 1998,101(1Pt 1):33-37. DOI: 10.1016/S0091-6749(98)70190-3 .
返回引文位置Google Scholar
百度学术
万方数据
[56]
Srisawat C , Nakponetong K , Benjasupattananun P ,et al. A preliminary study of intranasal epinephrine administration as a potential route for anaphylaxis treatment[J]. Asian Pac J Allergy Immunol, 2016,34(1):38-43.
返回引文位置Google Scholar
百度学术
万方数据
[57]
Campbell RL , Bellolio MF , Knutson BD ,et al. Epinephrine in anaphylaxis: higher risk of cardiovascular complications and overdose after administration of intravenous bolus epinephrine compared with intramuscular epinephrine[J]. J Allergy Clin Immunol Pract, 2015,3(1):76-80. DOI: 10.1016/j.jaip.2014.06.007 .
返回引文位置Google Scholar
百度学术
万方数据
[58]
Kawano T , Scheuermeyer FX , Gibo K ,et al. H1-antihistamines reduce progression to anaphylaxis among emergency department patients with allergic reactions[J]. Acad Emerg Med, 2017,24(6):733-741. DOI: 10.1111/acem.13147 .
返回引文位置Google Scholar
百度学术
万方数据
[59]
Mellem H , Lande K , Kjeldsen S E ,et al. Faster and more reliable absorption of adrenaline by aerosol inhalation than by subcutaneous injection[J]. Br J of Clin Pharmacol, 2012,31(6):677-681
返回引文位置Google Scholar
百度学术
万方数据
[60]
Safdar B , Cone DC , Pham KT . Subcutaneous epinephrine in the prehospital setting[J]. Prehosp Emerg Care, 2001,5(2):200-207. DOI: 10.1080/10903120190940137 .
返回引文位置Google Scholar
百度学术
万方数据
[61]
Cardona V , Ferré-Ybarz L , Guilarte M ,et al. Safety of adrenaline use in anaphylaxis: a multicentre register[J]. Int Arch Allergy Immunol, 2017,173(3):171-177. DOI: 10.1159/000477566 .
返回引文位置Google Scholar
百度学术
万方数据
[62]
Cluck DB , Odle B , Rikhye S . Therapeutic management of accidental epinephrine injection[J]. J Pharm Technol, 2013,29(3):123-129. DOI: 10.1177/875512251302900304 .
返回引文位置Google Scholar
百度学术
万方数据
[63]
Scranton SE , Gonzalez EG , Waibel KH . Incidence and characteristics of biphasic reactions after allergen immunotherapy[J]. J Allergy Clin Immunol, 2009,123(2):493-498. DOI: 10.1016/j.jaci.2008.10.026 .
返回引文位置Google Scholar
百度学术
万方数据
[64]
Michelson KA , Monuteaux MC , Neuman MI . Glucocorticoids and hospital length of stay for children with anaphylaxis: a retrospective study[J]. J Pediatr, 2015,167(3):719-724.e1-3. DOI: 10.1016/j.jpeds.2015.05.033 .
返回引文位置Google Scholar
百度学术
万方数据
[65]
Okubo Y , Michihata N , Morisaki N ,et al. Effects of glucocorticoids on hospitalized children with anaphylaxis[J]. Pediatr Emerg Care, 2018. DOI: 10.1097/PEC.0000000000001544 .
返回引文位置Google Scholar
百度学术
万方数据
[66]
Grunau BE , Wiens MO , Rowe BH ,et al. Emergency department corticosteroid use for allergy or anaphylaxis is not associated with decreased relapses[J]. Ann Emerg Med, 2015,66(4):381-389. DOI: 10.1016/j.annemergmed.2015.03.003 .
返回引文位置Google Scholar
百度学术
万方数据
[67]
Choo KJ , Simons E , Sheikh A . Glucocorticoids for the treatment of anaphylaxis: cochrane systematic review[J]. Allergy, 2010,65(10):1205-1211. DOI: 10.1111/j.1398-9995.2010.02424.x .
返回引文位置Google Scholar
百度学术
万方数据
[68]
Choo KJ , Simons FE , Sheikh A . Glucocorticoids for the treatment of anaphylaxis[J]. Evid Based Child Health, 2013,8(4):1276-1294. DOI: 10.1002/ebch.1925 .
返回引文位置Google Scholar
百度学术
万方数据
[69]
Pourmand A , Robinson C , Syed W ,et al. Biphasic anaphylaxis: a review of the literature and implications for emergency management[J]. Am J Emerg Med, 2018,36(8):1480-1485. DOI: 10.1016/j.ajem.2018.05.009 .
返回引文位置Google Scholar
百度学术
万方数据
[70]
Lee J , Rodio B , Lavelle J ,et al. The impact and safety of an updated anaphylaxis clinical pathway in a busy pediatric emergency department[J]. J Allergy Clin Immunol, 2017,139(2):AB222. DOI: 10.1016/j.jaci.2016.12.719 .
返回引文位置Google Scholar
百度学术
万方数据
[71]
中华人民共和国卫生部. 药品不良反应报告和监测管理办法[EB/OL]. ( 2011-05-04) [2018-05-30]. http://eng.sfda.gov.cn/WS01/CL1031/62621.html.
返回引文位置Google Scholar
百度学术
万方数据
Ministry of Health of the People′s Republic of China. Management measures for adverse drug reaction reporting and monitoring[EB/OL]. ( 2011-05-04) [2018-05-30]. http://eng.sfda.gov.cn/WS01/CL1031/62621.html.
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[72]
Brockow K , Schallmayer S , Beyer K ,et al. Effects of a structured educational intervention on knowledge and emergency management in patients at risk for anaphylaxis[J]. Allergy, 2015,70(2):227-235. DOI: 10.1111/all.12548 .
返回引文位置Google Scholar
百度学术
万方数据
[73]
Choo K , Sheikh A . Action plans for the long-term management of anaphylaxis: systematic review of effectiveness[J]. Clin Exp Allergy, 2007,37(7):1090-1094. DOI: 10.1111/j.1365-2222.2007.02711.x .
返回引文位置Google Scholar
百度学术
万方数据
[74]
de Silva HA , Pathmeswaran A , Ranasinha CD ,et al. Low-dose adrenaline, promethazine, and hydrocortisone in the prevention of acute adverse reactions to antivenom following snakebite: a randomised, double-blind, placebo-controlled trial[J]. PLoS Med, 2011,8(5):e1000435. DOI: 10.1371/journal.pmed.1000435 .
返回引文位置Google Scholar
百度学术
万方数据
[75]
Premawardhena AP , de Silva CE , Fonseka MM ,et al. Low dose subcutaneous adrenaline to prevent acute adverse reactions to antivenom serum in people bitten by snakes: randomised, placebo controlled trial[J]. BMJ, 1999,318(7190):1041-1043. DOI: 10.1136/bmj.318.7190.1041 .
返回引文位置Google Scholar
百度学术
万方数据
[76]
Fan HW , Marcopito LF , Cardoso JL ,et al. Sequential randomised and double blind trial of promethazine prophylaxis against early anaphylactic reactions to antivenom for bothrops snake bites[J]. BMJ, 1999,318(7196):1451-1452. DOI: 10.1136/bmj.318.7196.1451 .
返回引文位置Google Scholar
百度学术
万方数据
[77]
Kawano T , Grunau BE , Gibo K ,et al. LO066: H1-antihistamine administration is associated with a lower likelihood of progression to anaphylaxis among emergency department patients with allergic reactions[J]. CJEM, 2016,18(S1):S53. DOI: 10.1017/cem.2016.103 .
返回引文位置Google Scholar
百度学术
万方数据
[78]
陈辉，王骏，谢叶，等. 预防使用地塞米松在降低碘对比剂不良反应中的应用价值[J]. 中国临床研究， 2017,30(12):1665-1666. DOI: 10.13429/j.cnki.cjcr.2017.12.023 .
返回引文位置Google Scholar
百度学术
万方数据
Chen H , Wang J , Xie Y ,et al. Application value of preventive use of dexamethasone in reducing adverse reactions of iodine contrast agents[J]. Chin J Clin Res, 2017,30(12):1665-1666. DOI: 10.13429/j.cnki.cjcr.2017.12.023 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[79]
Tramèr MR , von EE , Loubeyre P ,et al. Pharmacological prevention of serious anaphylactic reactions due to iodinated contrast media: systematic review[J]. BMJ, 2006,333(7570):675. DOI: 10.1136/bmj.38905.634132.AE .
返回引文位置Google Scholar
百度学术
万方数据
[80]
Delaney A , Carter A , Fisher M . The prevention of anaphylactoid reactions to iodinated radiological contrast media: a systematic review[J]. BMC Med Imaging, 2006,6:2. DOI: 10.1186/1471-2342-6-2 .
返回引文位置Google Scholar
百度学术
万方数据
[81]
Habib AG . Effect of pre-medication on early adverse reactions following antivenom use in snakebite: a systematic review and meta-analysis[J]. Drug Saf, 2011,34(10):869-80. DOI: 10.2165/11592050-000000000-00000 .
返回引文位置Google Scholar
百度学术
万方数据
[82]
蔡和平，张铃铃，王卓，等. 两种含地塞米松的紫杉醇过敏反应预处理方案的Meta分析[J]. 中国临床药学杂志. 2012,21(2):90-95.
返回引文位置Google Scholar
百度学术
万方数据
Cai HP , Zang LL , Wang Z ,et al. Meta-analysis of therapeutic effect of two regimens contain dexamethasone to prevente paclitaxel′s hypersensitivity[J]. Chin J Clin Pharm, 2012,21(2):90-95.
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
备注信息
A
翟所迪，Email: mocdef.3ab61idousiahz
B
所有作者均声明不存在利益冲突
评论 （0条）
注册
登录
时间排序
暂无评论，发表第一条评论抢沙发
最新推荐
更多
高钾血症对慢性肾脏病3~5期未透析患者肾功能进展的影响
李金萍 等
中华医学杂志 2021,101(18)
中国透析患者高钾血症现状分析
黄娜娅 等
中华医学杂志 2021,101(42)
中国心力衰竭患者高钾血症管理专家共识
中国医师协会心血管内科医师分会心力衰竭学组 等
中华医学杂志 2021,101(42)
高钾血症和低钾血症危象
赵光远 等
中国小儿急救医学 2020,27(08)
MedAI助手（体验版）
文档即答
智问智答
机器翻译
回答内容由人工智能生成，我社无法保证其准确性和完整性，该生成内容不代表我们的态度或观点，仅供参考。
生成快照
文献快照

你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持：

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号
小中大