全身过敏反应

最后审阅: 26 八月 2022
最后更新: 05 五月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 急性发作
  • 气道肿胀(血管性水肿)
  • 吸气相鸣音和声音嘶哑
  • 呼吸短促
  • 喘息、胸部过度充气和辅助呼吸肌参与呼吸
  • 紫绀
  • 呼吸骤停
  • 面色苍白、皮肤湿冷
  • 低血压
  • 脉率增加(心动过速)
  • 心动过缓
  • 心搏骤停
  • 意识模糊或定向障碍
  • 荨麻疹(风团)
  • 红斑
  • 瘙痒
  • 血管性水肿
  • 鼻炎
  • 双侧结膜炎
完整详情

其他诊断因素

  • 危险因素
  • 恶心、呕吐、腹泻和失禁
  • 腹部绞痛和疼痛
  • 激越、焦虑和感到在劫难逃(死亡恐怖)
完整详情

危险因素

  • 成年:食物、昆虫毒素及药物相关
  • 30 岁以下人群:食物相关运动诱发
  • 女性
  • 特应性疾病/哮喘
  • 全身过敏反应既往史
  • 接触常见致敏物(例如乳胶)
完整详情

诊断性检查

首要检查

  • 肥大细胞类胰蛋白酶
  • 12 导联心电图
  • 尿素和电解质
  • 动脉血气分析
完整详情

需考虑的检查

  • 胸部 X 线检查
完整详情

治疗流程

初步治疗

疑诊全身过敏反应:心跳呼吸骤停

疑诊全身过敏反应:未出现心跳呼吸骤停

急症处理

初始治疗后:未出现心跳呼吸骤停

持续性治疗

全身过敏反应后

撰稿人

专家顾问

Alexander Alexiou, MB BS BSc DCH FRCEM Dip IMC RCSEd

Emergency Medicine Consultant

Barts Health NHS Trust

Physician Response Unit Consultant

London’s Air Ambulance

Royal London Hospital

London

UK

利益声明

AA declares that he has no competing interests.

Thomas Palmer, BSc MBChB FRCEM

ST6 Emergency Medicine

Royal London Hospital

London

UK

利益声明

TP declares that he has no competing interests.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:

Doerthe Adriana Andreae MD

Assistant Professor

Pediatric Allergy and Immunology

Penn State Health Milton S. Hershey Medical Center

Hershey

PA

Michael Henning Andreae MD

Associate Professor

Department of Anesthesiology

Penn State Health Milton S. Hershey Medical Center

Hershey

PA

利益声明

DAA is author of an UpToDate article on food allergy and a number of references cited in this topic. MHA is an author of a reference cited in this topic.

同行评议者

Robert Taylor, MBChB MRCP(UK) MRCP(London) DipMedTox DipTher PGDME FHEA FRCEM

Acute Hospital Sub Dean (Cornwall)

Honorary Clinical Senior Lecturer

Consultant Emergency Physician

The Knowledge Spa

Royal Cornwall Hospital

Truro

UK

利益声明

RT declares that he has no competing interests.

编辑

Celia Pincus,

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Rachel Wheeler,

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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