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患者女,56岁.以慢性咳、喘10余年.加重1周于1991年11月10日急诊就医.既往体健.查体:Bp17.3/10.6kPa,双肺可闻及散在干、湿罗音.心率90次/分,律齐,腹平软,肝、脾未触及.X线胸片示慢性支气管炎合并肺内感染.心电图示窦性心律,低血压.临床诊断:慢性支气管炎合并肺内感染.入院后给予甲硝唑250ml静点,此次发病以后未用其他药物治疗,静点甲硝唑液体20分钟后,患者出现手、足、面部奇痒.心悸,胸闷,呼吸困难,咽喉填塞感,声音嘶哑,头晕.Bp10.6/0kPa,心率130次/分,手、足、面部、腹部、四肢皮肤出现红色不规则斑丘疹.诊断为过敏性休克.立即停用甲硝唑,吸氧、肌注苯海拉明25mg,氟美松5mg,静点10%葡萄糖500ml加氢化考地松100mg,1小时后皮疹逐渐减退,血压14.6/9.3kPa,上述各种症状消失.甲硝唑副作用轻微.常见有消化道反应、头痛、失眠、皮疹,上述急性过敏致休克罕见.
Female patient, aged 56. With chronic cough, wheezing for more than 10 years.Every week in November 10, 1991 emergency medical treatment.Previous physical examination .Bucking: Bp17.3 / 10.6kPa, lungs can be heard and scattered in the dry and wet Luo Yin heart rate 90 beats / min, law Qi, abdominal soft, liver, spleen not touched.X-ray showed chronic bronchitis with pulmonary infection.Electrocardiogram shows sinus rhythm, hypotension.Clinical diagnosis: chronic bronchitis With pulmonary infection after admission metronidazole 250ml static point, after the onset of no other drug treatment, intravenous metronidazole liquid for 20 minutes, the patient appeared hand, foot, facial itching. Palpitations, chest tightness, breathing Difficulty, throat stuffy, hoarseness, dizziness.Bp10.6 / 0kPa, heart rate 130 beats / min, hand, foot, face, abdomen, limbs, skin irregular red rash. Diagnosis of anaphylactic shock. Nitroglycerin, oxygen, intramuscular injection of diphenhydramine 25mg, dexamethasone 5mg, static point 10% glucose 500ml hydrocortisone 100mg, 1 hour after the rash gradually decreased blood pressure 14.6 / 9.3kPa, the various symptoms Disappear metronidazole minor side effects common gastrointestinal reactions, headache, insomnia, rash, shock caused by the above-mentioned acute allergies rare.