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患者女,2岁,体重12kg,于2000年1月4日在全身麻醉、低温体外循环下行房间隔缺损修补术。手术顺利,心脏自动复跳,顺利脱离体外循环机,给予鱼精蛋白36mg按与肝素1∶1的比例静脉注射治疗,约5min后,患者面色苍白、大汗,四肢冰凉、湿冷,血压由95/60mm Hg突然降至45/30mm Hg,血氧饱和度下降至65％,全身荨麻疹、无尿。诊断为鱼精蛋白过敏反应,立即给予地塞米松5mg、苯海拉明20mg、葡萄糖酸钙500mg、多巴胺2mg静脉注射,并快速输血200ml,约30min后血压和血氧饱和度恢复正常,1h后荨麻疹消退,尿量80ml。术后病情平稳,7d出院。
Female, 2 years old, weighing 12 kg, was anesthetized on January 4, 2000, undergoing hypothermic cardiopulmonary bypass undergoing atrial septal defect repair. The operation was successful and the heart was automatically recalled. The patient was smoothly exuded from the cardiopulmonary bypass machine and given protamine 36 mg intravenously with heparin at a ratio of 1: 1. After about 5 minutes, the patient was pale and sweaty. His limbs were cold, / 60mm Hg suddenly dropped to 45 / 30mm Hg, oxygen saturation dropped to 65%, systemic urticaria, no urine. Diagnosed as protamine allergic reactions, immediately given dexamethasone 5mg, diphenhydramine 20mg, calcium gluconate 500mg, dopamine 2mg intravenous injection and rapid blood transfusion 200ml, about 30min after blood pressure and oxygen saturation returned to normal after 1h Hives subsided, urine output 80ml. Postoperative stable condition, 7d discharged.