摘要目的:调查急诊输液室严重药物过敏反应的临床特点及相关干预措施。方法:基于南京医科大学第一附属医院（我院）急诊医学中心急诊输液室建立的药物不良反应数据库，收集2019年11月至2023年11月发生严重过敏反应患者的临床资料，包括性别、年龄、既往药物不良反应史、过敏史、Charlson合并症指数，用药情况，严重药物过敏反应相关信息（发生时间、临床表现），干预措施，转归，以及随访情况；分析这些患者的临床特征和干预措施。结果:研究时段内，我院急诊输液室共398 772例患者接受药物静脉滴注治疗，其中发生药物不良反应者625例，75例发生了严重过敏反应。发生严重过敏反应者占总输液患者的0.02%（75/398 772），占发生药物不良反应患者的12.0%（75/625），其中Ⅱ级30例（40%）、Ⅲ级45例（60.0%），无Ⅳ级患者。75例严重过敏反应涉及药物多为抗感染药物（41，54.7%）。严重药物过敏反应临床表现多样，最常见的是心血管系统表现，主要为不同程度一过性的血压下降（67例，89.3%）；其次是全身表现和神经系统表现，主要为大汗（31例，41.3%）和头晕（28例，37.3%）。75例严重过敏反应患者均给予停药、更换输液器、快速评估循环和呼吸及监测生命体征等措施处理，其中65例（86.7%）给予快速静脉滴注补液扩容，6例（8.0%）接受了糖皮质激素静脉注射，3例（4.0%）给予0.5 mg肾上腺素肌内注射，2例（2.7%）给予抗组胺药。75例患者均症状改善，未发现后遗症或死亡病例。结论:急诊输液室中，严重药物过敏反应严重程度主要为Ⅱ级和Ⅲ级，及时干预预后较好；治疗措施以快速静脉滴注补液扩容为主，肾上腺素使用率较低。

abstractsObjective:To investigate the clinical characteristics and interventions associated with drug-induced anaphylaxis in the emergency infusion room.Methods:Bases on the adverse drug reaction database from the emergency medicine center of the First Affiliated Hospital of Nanjing Medical University, clinical data of patients who experienced drug-induced anaphylaxis in the emergency infusion room between November 2019 and November 2023 were collected, including gender, age, history of previous adverse drug reactions, allergy history, Charlson comorbidity index, medication details, information related to drug-induced anaphylaxis (onset time, clinical manifestations), interventions, outcomes, and follow-up. The clinical characteristics and interventions in these patients were analyzed.Results:During the study period, a total of 398 772 patients in the emergency infusion room in our hospital received intravenous infusion of drugs. Of them, 625 cases developed adverse drug reactions (ADRs) and 75 cases developed drug-induced anaphylaxis, accounting for 0.02% (75/398 772) of the total infusion patients and 12.0% (75/625) of all ADR cases. Of the 75 patients with anaphylaxis, 30 cases (40%) were classified as grade Ⅱ, and 45 cases (60%) as grade Ⅲ, with no grade Ⅳ cases. The most common drugs involved in 75 cases of anaphylaxis were anti-infective drugs (41 cases, 54.7%). Drug-induced anaphylaxis exhibited diverse clinical manifestations, with cardiovascular symptoms being the most common, primarily varying degrees of transient hypotension (67 cases, 89.3%), followed by systemic and neurological symptoms, including profuse sweating (31 cases, 41.3%) and dizziness (28 cases, 37.3%). All 75 patients with anaphylaxis were treated with measures such as discontinuation of medication, replacement of infusion sets, rapid assessment of circulation and respiration, and monitoring of vital signs, of which 65 (86.7%) received rapid intravenous infusion for volume expansion, 6 (8.0%) received intravenous injection of glucocorticoids, 3 (4.0%) received intramuscular injection of 0.5 mg epinephrine, and 2 (2.7%) received antihistamines. All 75 patients showed improvement in symptoms, and no sequelae or deaths were found.Conclusions:In the emergency infusion room, the severity of anaphylaxis is mainly grade Ⅱ and Ⅲ with a good prognosis after timely intervention. The treatment measures mainly focus on rapid intravenous infusion for volume expansion, and the use of epinephrine is relatively low.