Vitamin K1引起之全身型過敏反應(anaphylaxis)

全身型過敏性反應(anaphylaxis)是一種快速發生地，接觸過敏原後經由免疫球蛋白E(IgE)為媒介，使肥胖組織細胞(mast cell)與周邊血流嗜鹼性白血球釋放出強力免疫介質，所造成的立即性全身性過敏反應。全身型過敏性反應臨床症狀的嚴重度、起始時間、和病程是因人而異，它可由輕微的全身病變至嚴重到咽喉水腫、心血管衰竭，甚至因而死亡。本篇報告一例因注射phytonadione(vitamin K1)而造成全身型過敏性反應。病患因大腸瘜肉預定做右半大腸割除手術住院，並於晚間作術前腸道準備，在靜脈注射vitamin K1約2分鐘時，出現全身型過敏性休克。文獻回顧建議在靜脈注射前，應先詢問病人是否曾對vitamin K1、助溶劑polyethoxylated castor oil(PEO-CO)與propylene glycol等過敏；最好以小於0.5-1 mg/min的速率靜脈注射，同時監測病人的生命徵象包括血壓、脈搏、呼吸，且在輸注vitamin K1前、注射15分鐘後與輸注完畢各監測一次，以策安全。

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並列摘要

Anaphylaxis is an immediate systemic hypersensitivity reaction caused by immunoglobulin (Ig) E-mediated immunological release of potent mediators from tissue mast cells and basophils. The degree of severity, the initiating time, and the process of anaphylaxis reaction vary among individuals. The clinical symptoms range in severity from mild systemic effects to laryngeal edema, circulatory collapse, and even death. This article reports a case of anaphylactic reaction induced by phytonadione (vitamin K1) infusion. The patient was admitted to the hospital for a colon tumor and was scheduled for right hemicolectomy. During preoperative bowel preparation, two minutes after initiating vitamin K1 infusion, anaphylactic shock occurred and prompted necessitating CPR. After a literature review, it is suggested that the following steps should be taken prior to intravenous infusion of vitamin K1 to ensure patient safety: first determine whether the patient has a allergic history of vitamin K1 or solubilizers such as polyethoxylated castor oil (PEO-CO) or propylene glycol; if not, maintain vitamin K1 infusion rate at less than 0.5-1 mg/min; close monitoring the patient's vital signs (blood pressure, pulse, respiration) prior to, during (fifteen minutes after infusion begins) and after the vitamin K1 infusion.

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vitamin K1 ； anaphylaxis

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Vitamin K1引起之全身型過敏反應(anaphylaxis)

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