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1例48岁男性患者因脑脓肿伴继发性癫痫行左侧颞部占位性病变切除术,术后第1天依次静脉滴注单唾液酸四己糖神经节苷脂钠注射液40 mg、青霉素钠320万U(皮肤试验阴性)。药物滴注完毕后约5 min患者出现躁动、口唇发绀、双肺呼吸音粗,可闻痰鸣音,呼吸频率30～40次/min,心率178次/min,血压80～88/48～60 mm Hg(1 mm Hg=0.133 kPa),血氧饱和度0.60。立即予口咽通气管,吸痰,面罩吸氧,气管插管呼吸机辅助呼吸,静脉滴注多巴胺100 mg、间羟胺40 mg、甲泼尼龙0.5 g,静脉注射去乙酰毛花苷0.2 mg、地塞米松4 mg。2 h后患者心率降至110次/min,呼吸频率降至19次/min,血压升至125～135/70～90 mm Hg,血氧饱和度升至1.00,生命体征趋平稳。怀疑休克与青霉素有关。次日停用青霉素,继续静脉滴注氯化钠注射液100 ml+单唾液酸四己糖神经节苷脂钠40 mg,10 min后患者再次出现躁动、呼吸急促,心率增快至160次/min,血氧饱和度降至0.85,血压降至77/45 mm Hg。立即停止静脉滴注,给予呼吸机辅助呼吸以及升压、降低心率、抗过敏、抗炎等对症治疗。40 min后,患者心率降至110次/min,呼吸频率降至18次/min,血压升至110～145/60～90mmHg,血氧饱和度0.98,生命体征平稳。
A 48-year-old male patient underwent resection of the left temporal occupying lesion due to brain abscess with secondary epilepsy. On the first postoperative day, a single intravenous infusion of monosialotetrahexosyl ganglioside sodium injection 40 mg , Penicillin sodium 3.2 million U (skin test negative). Approximately 5 minutes after the instillation of the drug, the patient developed agitation, cyanosis of the lips, rough breathing sounds of the lungs, phlegm-breathing sounds, respiratory rate of 30 to 40 beats / min, heart rate of 178 beats / min, and blood pressure of 80 to 88/48 to 60 mm Hg (1 mm Hg = 0.133 kPa), oxygen saturation of 0.60. Immediately to the oropharyngeal airway, suction, mask oxygen, ventilator assisted breathing endotracheal intubation, intravenous infusion of dopamine 100 mg, hydroxylamine 40 mg, methylprednisolone 0.5 g, intravenous acetylation Mao Mao glycosides 0.2 mg, Dexamethasone 4 mg. After 2 hours, the heart rate of the patients dropped to 110 beats / min, the respiratory rate decreased to 19 beats / min, the blood pressure increased to 125-35 / 70-90 mm Hg, and the oxygen saturation rose to 1.00. The vital signs tended to be stable. Suspected shock and penicillin related. The next day to disable penicillin, intravenous infusion of sodium chloride injection of 100 ml + monosialotetrahexosyl ganglioside sodium 40 mg, 10 minutes after the patient again agitation, shortness of breath, heart rate increased to 160 beats / min , Oxygen saturation dropped to 0.85 and blood pressure dropped to 77/45 mm Hg. Immediately stop intravenous drip, ventilator-assisted breathing and boost, reduce heart rate, anti-allergy, anti-inflammatory symptomatic treatment. After 40 minutes, the patient’s heart rate dropped to 110 beats / min, the respiratory rate dropped to 18 beats / min, blood pressure rose to 110 to 145/60 to 90 mmHg, oxygen saturation of 0.98, and vital signs were stable.