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1例43岁男性患者,因脊髓损伤后双下肢痛入院行手术治疗。入院时BP 157/100 mm Hg。术中行麻醉诱导后BP110/70 mm Hg,随后将患者由仰卧变为俯卧,给予头孢曲松2 g入0.9%氯化钠注射液100 ml静脉滴注,几分钟后患者出现血压下降,BP 60/40 mm Hg,HR 100次/min,ECG出现T波倒置。考虑为麻醉后体位性低血压,经处理后情况好转,手术顺利完成。术后生命体征平稳,第2天再次给予头孢曲松静脉滴注,滴入10 ml后患者突然出现全身痒、胸闷、大汗及呼吸困难。BP70/40 mm Hg,HR 130次/min,SpO20.80。立即停用头孢曲松,给予抗过敏、扩容及抗休克等治疗,症状逐渐消失,血压平稳。
A 43-year-old male patient was admitted to the hospital for surgical treatment of bilateral lower extremity pain after spinal cord injury. BP 157/100 mm Hg on admission. Postoperative anesthesia BP110 / 70 mm Hg after induction, and then the patient supine into prone position, given ceftriaxone 2 g 0.9% sodium chloride injection 100 ml intravenous infusion, a few minutes after the patient’s blood pressure dropped, BP 60 / 40 mm Hg, HR 100 beats / min, ECG appears T wave inversion. Considered post-anesthetic orthostatic hypotension, the situation improved after treatment, the surgery was successfully completed. Postoperative vital signs were stable. On the second day, ceftriaxone was given intravenously once again. After dripping 10 ml, the patient suddenly developed systemic itching, chest tightness, sweating and dyspnea. BP70 / 40 mm Hg, HR 130 times / min, SpO20.80. Stop using ceftriaxone immediately and give anti-allergy, dilatation and anti-shock treatment, the symptoms gradually disappear, blood pressure is stable.