全身过敏反应

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Last reviewed: 23 Jun 2024
Last updated: 17 Jan 2023

Summary

Definition

History and exam

Key diagnostic factors

  • 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
Full details

Other diagnostic factors

  • 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)
Full details

Risk factors

  • 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)
Full details

Diagnostic tests

1st tests to order

  • 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
Full details

Tests to consider

  • 胸部 X 线检查
Full details

Treatment algorithm

INITIAL

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

ACUTE

初始治疗后:未出现心跳呼吸骤停

ONGOING

全身过敏反应后

Contributors

Expert advisers

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

Disclosures

AA declares that he has no competing interests.

Thomas Palmer, BSc MBChB FRCEM

ST6 Emergency Medicine

Royal London Hospital

London

UK

Disclosures

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

Disclosures

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.

Peer reviewers

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

Disclosures

RT declares that he has no competing interests.

Editors

Celia Pincus

Section Editor, BMJ Best Practice

Disclosures

CP declares that she has no competing interests.

Susan Mayor

Lead Section Editor, BMJ Best Practice

Disclosures

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

Disclosures

RW declares that she has no competing interests.

Julie Costello

Comorbidities Editor, BMJ Best Practice

Disclosures

JC declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

Disclosures

AM declares that he has no competing interests.

  • 全身过敏反应 images
  • Differentials

    • 脓毒性休克
    • 心源性休克
    • 低血容量休克
    More Differentials
  • Guidelines

    • EAACI 指南:全身过敏反应
    • 严重过敏反应的急诊处理
    More Guidelines
  • Videos

    气管插管的动画演示

    球囊面罩通气的动画演示

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  • Patient information

    全身过敏反应

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