诊所输液出事，又是这种常用药…

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                    <section data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section><section><section><section><section><section><section><section><section><section><section><section><section><section><section><section><section><section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.jpg" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械媒体报道先锋</span></p><p><span>分享专业医疗器械知识</span></p></section><section><section><section><span>关注</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section data-id="97965" data-tools="gulangu"><section><section><section><section><section><p><br  /></p></section><section powered-by="gulangu"><p><span>来源：基层医师公社</span></p><p><span>编辑：</span><span><strong><span>晓琳</span></strong></span></p><section data-role="outer" label="Powered by gulangu"><section data-role="outer" label="Powered by gulangu"><section data-role="outer" label="Powered by gulangu"><section data-role="outer" label="Powered by gulangu"><p><br  /></p><section data-role="outer" label="Powered by gulangu"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section data-role="paragraph"><section><section><section><section><section><section><p><strong>慎重！中药注射液又出事了</strong></p></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section data-role="outer" label="Powered by 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data-role="paragraph"><section><span>近日，河南省郑州市邢先生的爱人因身体不适前往某中医诊所看病，结果输了几瓶液后邢先生爱人出事了……</span></section><section><section><section><section><section><section><p><br  /></p></section></section></section></section></section></section><section><span><strong>处方曝光！中药注射液清开灵惹祸</strong></span></section><section><span><strong><br  /></strong></span></section><section><span>中医诊所医生表示，邢先生爱人可能是中暑，</span><span>于是为其注射了清开灵注射液。没几分钟，邢先生爱人的眼睛却肿成了核桃。</span></section><section><br  /></section><section><span>邢先生立即拨打了120，前往救治的大医院医生表示是注射清开灵注射液导致的过敏现象。</span><span>现在邢先生爱人不仅头疼脑热没治好，还治成了药物过敏。</span></section><section><br  /></section><section><span>为此，中医诊所医生表示，清开灵注射液不需要做皮试，且注射之前也问过邢先生爱人对该药物是否过敏，对方回答的是没有。</span></section><section><br  /></section><section><span>前往救治的大医院医生表示，</span><span>清开灵注射液百分之六七十的人都会存在药物过敏</span><span>，对此中医诊所的医生却说他们不知道。</span></section><section><br  /></section><section><span>最后，中医诊所医生承认自己在工作中存在一定的过失，表示会积极承担相应的责任。</span></section><section><section><section><section><section><section><p><br  /></p></section></section></section></section></section></section><section><span><strong>清开灵注射液不良反应可致死</strong></span></section><section><span><strong>国家多次通报</strong></span></section><section><br  /></section><section><span>笔者认为，作为一名基层医生不知道清开灵注射液的不良反应实属不该。</span></section><section><br  /></section><section><span>早在2001年11月，国家药品不良反应监测中心首次通报了清开灵注射剂引起的过敏反应。</span></section><section><br  /></section><section><span>2009年，国家药品不良反应监测中心再次发布有关通报，警惕清开灵注射液的严重不良反应，并可能导致死亡。</span></section><section><br  /></section><section><span>清开灵注射剂死亡病例报告分析显示：81%的患者存在合并用药情况，8%存在多种药品混合静脉滴注的情况；</span></section><section><br  /></section><section><span>合并用药品种在1-6种之间，</span><span>主要为利巴韦林、头孢噻肟钠、地塞米松、林可霉素、双黄连注射剂、头孢曲松钠、头孢唑啉钠、左氧氟沙星、阿奇霉素、青霉素、庆大霉素、氨茶碱、阿米卡星等。</span></section><section><br  /></section><section><span>死亡主要原因为过敏性休克、多脏器功能衰竭、猝死、急性左心</span><span>衰等；除药品因素外，不排除原患疾病进展、合并用药、混合配伍、过敏体质、救治不及时或不当等因素。</span></section><section><section><section><section><section><section><p><br  /></p></section></section></section></section></section></section><section><span><strong><span>慎重！中药注射液不良反应</span></strong></span></section><section><span><strong><span>报告数目仅次于抗生素</span></strong></span></section><section><br  /></section><section><span>中药注射液成分复杂，不良反应报告数目仅次于抗生素。西药注射剂多为单一成分，而中药注射制剂制备过程比西药复杂的多，使用时真的要万分小心。</span></section><section><br  /></section><section><span>以清开灵注射液为例，主要由胆酸、珍珠母（粉）、猪去氧胆酸、栀子、水牛角（粉）、板蓝根、黄芩苷和金银花制备成的中药复方制剂。</span></section><section><br  /></section><section><span>金银花所含的绿原酸对人体有致敏作用，板蓝根可损伤骨髓细胞，桅子乙醇对肝脏有毒性。水牛角含有的胆甾醇、蛋白质及水解产物等抗原物质，在体内会激发某些敏感抗体形成，积聚后导致过敏。</span></section><section><section><section><section><section><section><p><br  /></p></section></section></section></section></section></section><section><span><strong><span>致所有基层医生，这5点建议须记牢</span></strong></span></section><section><br  /></section><section><span>若基层医生必须要使用清开灵注射液，下面5点建议须记牢：</span></section><section><br  /></section><section><span>1.应充分了解清开灵注射剂的功能主治，严格掌握其适应症，权衡患者的治疗利弊，谨慎用药。</span></section><section><br  /></section><section><span>2.应在用药前仔细询问患者的过敏史，对使用该产品曾发生过不良反应的患者、过敏体质的患者（包括对其他药品易产生过敏反应的患者），不宜使用该产品治疗。</span></section><section><br  /></section><section><span>3.</span><span>清开灵注射剂应单独使用，禁忌与其他药品混合配伍；谨慎联合用药，如确需联合其他药品时，应谨慎考虑与清开灵注射剂的时间间隔以及药物相互作用等因素</span><span>。</span></section><section><br  /></section><section><span>4.应严格按照说明书规定的用法用量给药，不得超剂量、高浓度应用；对于老年人、儿童患者应谨慎使用；用药期间密切观察，发现异常应及时停用清开灵注射剂，并及时采取救治措施。</span></section><section><br  /></section><section><span>5.对于医疗救治能力相对薄弱的基层医疗机构，应严格按照《关于进一步加强中药注射剂生产和临床使用管理的通知》，谨慎使用清开灵注射剂。</span></section><section><br  /></section><section><span>国家一直倡导，能口服不肌注，能肌注不输液。若仅是上述出现的中暑现象，笔者认为完全没有必要进行输液处理，而且还是风险极高的中药注射液，当心将自己卷入危险之中。</span></section></section></section><p><br  /></p></section></section></section></section><section><section><section 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