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围手术期全身性过敏反应：复发反应的评估与预防

Author
Dennis K Ledford, MD
Section Editor
N Franklin Adkinson, Jr, MD
Deputy Editor
Anna M Feldweg, MD
Translators
戚峰, 教授

引言

全身性过敏反应(anaphylaxis)是一种可致死的严重多系统变态反应。本文中，“全身性过敏反应”所指包括IgE介导和非IgE介导的反应。本文将总结围手术期全身性过敏反应患者的评估及随后麻醉期间避免反应复发的策略。围手术期全身性过敏反应的患病率、病因、临床表现、诊断及鉴别诊断将单独讨论。 (参见“围手术期全身性过敏反应的临床表现、病因及治疗”)

全身性过敏反应的治疗见其他专题。 (参见“Anaphylaxis: Emergency treatment”)

评估

对于围手术期或围麻醉期全身性过敏反应患者的评估包括：采集临床病史，回顾过敏反应事件记录，分析发病时进行的实验室检查结果，并且当怀疑为IgE介导反应时可能需做皮试。麻醉及手术所用药物较为复杂，给确定致敏原带来了难度，但对临床信息及所选检查结果的关键性解读可帮助更好地识别致敏药物[1]。

评估有2个目的：

●确定致敏原以便在今后避免接触，若未能发现致敏原，则需使用多种二线药物，但这一策略也并非没有风险。

                                          

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Literature review current through: 2017-07 . | This topic last updated: 2017-06-13.
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