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患儿男,10岁,于1997年5月9日下午3时许在学校注射乙脑疫苗1h后突然出现全身皮疹,以四肢为主,同时伴有手足部皮肤肿胀,搔痒感明显,伴有头晕、腹部不适及恶心,随后患儿出现面色苍白、全身湿冷,急来医院就诊。查体:T 35℃、P 48次/min、R 22次/min、BP 75/45mmHg(10/6hPa),神清,精神恍惚,全身皮肤湿冷及散在风团样皮疹,皮疹高起皮面,脉搏细弱,面色苍白,双侧瞳孔等大,对光反射灵敏,心律齐,心音低钝。诊断:乙脑疫苗致过敏性休克。立即肌注氟美松5mg及吸氧后收入院。除吸氧外,经静滴葡萄糖酸钙与维生素C、肌注氟美松、口服扑尔敏等抗过敏及青霉素预防感染等治疗,8h后休克症状缓解,全身皮肤温暖,面色转红润,皮疹渐消退,搔痒感消失,精神稍差,心率90次/min,心音有力,血压稳定并恢复正常。
Children aged 10 years old, at 9 o’clock on May 9, 1997 at 3 pm in the school injection of Japanese encephalitis vaccine 1h after the sudden emergence of systemic rash to limbs, accompanied by hand and foot skin swelling, itching was obvious, accompanied by Dizziness, abdominal discomfort and nausea, followed by pale children appear, body wet, anxious to the hospital. Examination: T 35 ℃, P 48 times / min, R 22 times / min, BP 75/45 mmHg (10 / 6hPa), Shen Qing, trance, systemic skin wet and scattered wind-like rash, , Weak pulse, pale, bilateral pupils and other large, sensitive to light reflection, heart Qi Qi, heart sound low blunt. Diagnosis: JE vaccine induced anaphylactic shock. Immediate intramuscular dexamethasone 5mg and oxygen after admission hospital. In addition to oxygen, intravenous infusion of calcium gluconate and vitamin C, intramuscular meflulin, oral chlorpheniramine and other anti-allergic and penicillin prevention of infection and other treatment, shock relief after 8h, the whole body warm skin, face turn red, rash Gradually subsided, itching disappeared, the spirit of a little worse, heart rate 90 beats / min, heart sound, blood pressure and return to normal.