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老太输液致死疑因药物过敏 引发头孢皮试标准反思--亲稳舆论引导监测室
2012-08-07
“头孢”做皮试,竟无统一标准 “cephalosporins”Have a skin test,But there is no unified standard
医护人员操作起来也无所适从,有的选择参照青霉素皮试标准 Medical personnel to operate up also nowhere,Some choose refer to penicillin skin test criteria
济南66岁赵广芸老人虽然在输头孢之前做了皮试,但没能避免悲剧的发生。据专家介绍,目前我国并没有强制规定注射头孢必须做皮试,虽然多数医疗机构出于安全考虑都会选择皮试,但因为没有统一的标准,医护人员具体操作起来也有些无所适从。
Jinan 66-year-old old man lost in ZhaoGuangYun though the skin test before cephalosporins,But he can't avoid the tragedy occurrence。According to expert introduction,At present our country and no compulsory cephalosporins injection must do skin test,Though most of the medical institution for safety will choose a skin test,But because there is no unified standard,Medical personnel specific operation up some disoriented。
“头孢”是否皮试,药典没有规定 “cephalosporins”Skin test whether,Pharmacopoeia no provisions
“在中国药典中,没有规定要求在使用这类药品时必须要进行皮试。”山东省药学会抗菌药物临床应用专业委员会主任委员、齐鲁医院药剂科主任周文介绍,因为头孢类皮试结果中,假阳性和假阴性的比例相对较高,所以即使做皮试,也不能完全避免过敏反应等。记者查询2010年版的中国药典临床用药须知,也未发现相关规定。
“In China pharmacopoeia,No requirements in the use of such drugs must be take a skin test。”Shandong province antibacterial drugs for clinical use medicine professional committee of the chairman of the committee、Qilu hospital pharmacy department director introduce relevant,Because of cephalosporins skin test result,False positives and false negatives proportion of relatively high,So even if have a skin test,Also cannot avoid completely allergic reaction, etc。Reporter inquires the 2010 edition of the China pharmacopoeia notes to clinical application,Also not find related provisions。
“之所以没有强制规定,主要原因是学术界对头孢类药品是否必须做皮试尚未达成一致意见。”山东省药品不良反应监测中心副主任田月洁也表示,2005年,该中心曾组织省内专家就这一问题进行专题研讨,大部分与会专家认为,尽管存在假阳性的可能,但毕竟能将一部分敏感人群排除,建议此类药品使用时做皮试。但至今国家相关部门没有出台相关规定。
“Are not mandatory,The main reason is the academic circles to cephalosporin drugs must have a skin test whether have not yet come to an agreement。”Shandong province adverse drug reaction monitoring center on clean, deputy director of the field also said,2005 years,The center was in the organization experts problems in workshops,Most of the experts say,Despite the possibility of false positives,But after all, can will be part of sensitive crowd ruled out,Drug use suggests such do when skin test。But has relevant national authorities not to publish relevant regulations。
省内一位药学专家说,自己曾碰到过一个案例:在为患者进行皮试后显示是阳性,因此未给其注射。后来这名患者在其他医疗机构注射了该药,并没有过敏反应,还找了回来。如果皮试呈假阴性,输液后又发生了过敏反应,问题将更麻烦。
Province a pharmacy experts said,He had met a case:In patients with skin test for that is positive,So did not give the injection。Then the patients in other medical institutions given the drug,And no allergic reaction,Also look for a back。If skin try a false negatie,After infusion and happened allergic reaction,Problems will be more trouble。
即使做皮试,也无统一标准 Even if have a skin test,Also there is no unified standard
6日,记者采访了省城多家社区卫生机构,大都表示新规实施后已无此类药物,但之前使用时他们都会给患者做皮试。
6,,The reporter interviewed several community health institutions provincial capital,Most of the new rule to implement without having said these drugs,But before use, they will give patients have a skin test。
周文也表示,据她了解,目前超过90%的医疗机构使用此类药品时都会做皮试。但与公众熟悉的青霉素皮试不同,由于国家目前没有此类药品做皮试的具体方法,各医疗机构在进行皮试时也没有相对统一的标准。
Relevant also said,According to her understand,At present, more than 90% of the medical institutions to use such drugs do skin test。But with the public familiar penicillin skin try different,Due to the countries now does not have this kind of medicine have a skin test method of concrete,Various medical agencies also no relative skin test standard。
“做皮试是出于安全的考虑,尽量减少意外的发生。”一家社区卫生服务机构的负责人说,这样做也是为患者负责。
“Have a skin test is because of safety concerns,Try to reduce the accident from happening。”A community health service officials said,It was responsible for patients。
该负责人说,相关部门非常有必要制定标准。“尤其是对我们基层医护人员来说,很多时候我们无所适从,现在做皮试只能参照青霉素的标准。”
The official said,It is necessary to formulate relevant department very standard。“Especially for our medical researchers to grassroots,Many times we get nothing done,Now have a skin test can only refer to the standard of penicillin。”
专家说法 Experts said
过敏不可怕,急救要得当 Allergy is not terrible,First aid to properly
“做皮试也不能预防过敏反应,那还能用这类药吗?”在得知这一事件后,因家里有老人经常需要输液,张女士表示很担心,也说出了许多市民心里的疑问。
“Have a skin test also can't prevent allergic reaction,That still can use this kind of medicine?”In the event that,Because his family have the old man often need transfusion,Ms. Zhang said worried,Also tell the many citizens in the heart of the question。
“过敏反应并不可怕。”田月洁说,药品的不良反应是不可能完全杜绝的,像头孢类药品,从多年的实践看,发生过敏反应虽然比较多,但其后果并非不可接受。“用药前,医生要仔细询问病人的过敏史,这可以过滤掉一部分危险;用药过程中,医护人员要密切观察,一旦发现不良反应,要立即停药并采取救治措施。”
“Allergic reaction is not fearful。”Field month jie says,Drug adverse reaction is can't completely put an end to,Like cephalosporin drugs,From years of practice look,Produce allergic reaction although more,But the consequences are not cannot accept。“Before drug,The doctor asked the patient carefully the allergy,This can filter out part of the danger;Drug use in the process,Medical personnel to closely observe,Once found adverse reactions,To immediately stop and take medicine treatment measures。”
“对于过敏性休克等严重反应,应采取停药,保持呼吸畅通,吸氧,注射肾上腺素、糖皮质激素等。”田月洁说,出现过敏反应并不可怕,可怕的是不能及时、恰当地抢救。
“For severe anaphylactic shock response,Stop drug should be taken,Keep breathe smoothly,oxygen,Epinephrine injection、Corticosteroids, etc。”Field month jie says,Appear allergic reaction is not fearful,Terrible is not timely、Appropriate to save。
在该中心监测的数据中,因过敏反应而死亡的病例很少,只要采取了及时有效的救治措施,绝大多数过敏患者都能恢复正常。(记者 李钢 实习生 李钰 朱琳)
In the center of the monitoring data,For allergic reaction to death of cases rarely,As long as adopted timely and effective treatment measures,Most patients are allergic to return to normal。(Reporter LiGang interns LiYu yutao)
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