儿童食物过敏应随身携带2剂剂量的急救药品

推荐一个在急救部门的方法审查的食物过敏反应

2010年3月24日

波士顿，大众。在急救科大六年回顾（ED）的数据，研究人员在波士顿儿童医院，在马萨诸塞州总医院合作，发现很多孩子有严重的食物过敏需要一个剂量的肾上腺素，提示患者应进行承载epipens两剂量而不是一个。

1997、学龄儿童人数食物过敏据疾病控制和预防中心增加了近百分之20。这项研究，出版在四月的问题儿科，是迄今为止规模最大的研究食物过敏儿童急救治疗，根据作者。

"Food allergies are an increasingly important topic in pediatrics," says Susan Rudders, MD, of Children's Division of Allergy and Immunology and first author of the paper。 "There's not a lot of data about the epidemiology of 食物过敏 because it's a hard thing to study。" Difficulties imposed on previous studies included insensitive clinical tests for 食物过敏 -- such as through a skin test or blood test -- and lack of a universally accepted definition of anaphylaxis。

在回顾下18两个波士顿急诊从2001到2006个孩子的图表，研究人员确定了1255名儿童因食物过敏反应考察。其中，有一半以上的过敏反应，包括至少两个器官系统或低血压最严重的过敏反应（如定义的国家过敏和传染病研究所和食物过敏与过敏反应网络2006）。常见的症状包括呼吸困难、皮疹、肿胀和胃肠道问题。

这些过敏儿童给予肾上腺素，百分之12需要一个以上的剂量因为症状再次出现，之前或之后被带到版，这一发现与先前的研究一致的小。

“直到我们弄清楚最严重反应的危险因素，最安全的方法就是给所有食物过敏反应儿童携带两剂量的肾上腺素回家。为抵消增加的成本，Rudders建议学校的护士办公室进行未分配的额外剂量的肾上腺素注射剂给有需要的孩子。

该研究也描述了两个EDS研究过敏治疗状态在2001-2006年间，表明EDS可能并不总是遵循现行的实践指南，并没有因为1998大改变。目前的实践指南推荐的食物过敏反应治疗方案：医生使用肾上腺素作为一线治疗，是指患者的变态反应，指导患者避免可疑食品和处方可自我注射的肾上腺素。

However, consistent with trends seen nationwide, emergency physicians were more likely to treat children in the emergency department with corticosteroids and antihistamines。 Upon discharge from the ED, less than half of patients were prescribed epinephrine, and even fewer were referred to an allergist or received instructions on avoiding suspected foods。 These last recommendations are important in light of the fact that 44 percent of the children studied had a known history of 食物过敏, but still ate these foods accidentally。

这些结果可能是由于缺乏在ED的过敏反应一个普遍认识2006之前，回家。在知识的差距已经关闭以来，和舵希望她的研究能推动事情的发展。

"As 食物过敏 are becoming more prominent in the media, some of these [shortcomings] will catch up," Rudders says。 "Recognizing anaphylaxis, promptly treating with epinephrine and sending children home with self-injectable epinephrine are going to become increasingly important。"

舵的支持国立卫生研究院。和卡洛斯，小，医学博士，公共卫生学博士是马萨诸塞州总医院的资深作者。

引文：苏珊A。舵，该贝纳杰，布兰卡Corel，星期日克拉克，卡洛斯A。 Camargo，食物过敏反应的重复肾上腺素治疗：多中心研究”。儿科2010年3月22日（在线）。

接触：
克里斯特德曼
617-919-3110
keri。stedman@childrens。harvard。edu

波士顿儿童医院 is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869。 More than 500 scientists, including eight members of the National Academy of Sciences, 13 members of the Institute of Medicine and 12 members of the Howard Hughes Medical Institute comprise Children's research community。 Founded as a 20-bed hospital for children, 波士顿儿童医院 today is a 396-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families。 Children's also is the primary pediatric teaching affiliate of Harvard Medical School。 For more information about the hospital and its research visit:www。childrenshospital。org\/newsroom。

（注：转载时请注明复诊网）