摘要
Abstract
Objective To summarize the causes of misdiagnosis and preventive measures in patients with anaphylac-tic shock caused by anti-infective central venous catheter.Methods From August 2010 to November 2023,the clinical data of 2 patients with anaphylactic shock caused by anti-infective central venous catheter were retrospectively analyzed.Results A patient was hospitalized due to perineal cicatricial contracture deformity after burn for 2 years.After perineal cicatrictomy and plastic surgery was proposed,anaphylaxis occurred after anti-infective central venous catheter was inserted.Considering allergy to Lidocaine or Propofol,the condition was improved after anaphylaxis treatment.Bilateral popliteal scar resection and skin grafting were reperformed,and anaphylactic shock occurred after the above-mentioned catheter was inserted.Considering two allergies,anaphylactic shock caused by anti-infective central venous catheter was diagnosed.The misdiagnosis lasted 17 d.Another patient with left lower limb damage caused by falling material,multiple fractures and hemorrhagic shock for 1 h was admitted to hospital.After symptomatic treatment,the condition was stabilized,skin and soft tissue reconstruction was proposed,anti-infective central venous catheter placement and intravenous infusion of Cefuroxime Sodium were given,and al-lergic reaction occurred.Considering allergy to Cefuroxime Sodium,the condition was improved after anti-allergic treatment.Residual wound skin grafting+scalp skin extraction was reperformed.Anaphylactic shock occurred after the above-mentioned catheter was inserted.Considering allergy for two times,anaphylactic shock caused by anti-infective central venous catheter was diagnosed.The misdiagnosis lasted 24 d.After timely rescue,the vital signs of the two patients were stable,and they were discharged from hospital after operation.Conclusion Anaphylactic shock caused by anti-infective central venous cathe-ter is prone to misdiagnosis.Strict selection of indications,detailed understanding of patient history,close observation of dis-ease changes during catheterization,and strengthening communication between clinicians and anesthesiologists are all helpful to prevent misdiagnosis.关键词
抗感染中心静脉导管/过敏性休克/误诊/利多卡因/丙泊酚/头孢呋辛钠/诊断Key words
Anti-infective central venous catheter/Anaphylactic shock/Misdiagnosis/Lidocaine/Propofol/Cefu-roxime sodium/Diagnosis分类
医药卫生
