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1、.精选范本各种皮试液配制方法青霉素皮试药液配制方法:青霉素 1 瓶 80 万 u,注入 4ml 生理盐水,则1ml 含 20 万 u 取 0.1ml,加生理盐水至1ml,则 1ml 含 2 万 u 取 0.1ml,加生理盐水至1ml,则 1ml 含 2000u 取 0.25ml,加生理盐水至1ml,则 1ml 含 500u,即成青霉素皮试液。皮内注射0.1ml 含 50 u,20 分钟后查看皮试结果。头孢类药物皮试液配制方法,以0.5g剂量为例如:头孢拉定 0.5g/瓶、头孢呋新钠0.5g/瓶、头孢地嗪钠0.5g/瓶、头孢派酮钠舒巴坦钠0.5g/瓶、头孢唑林钠0.5g/瓶:以上所需药物加生理盐
2、水溶解至2ml;(250mg/ml)取上液 0.1ml+生理盐水至1ml;(25 mg/ml)取上液 0.1ml+生理盐水至1ml;(2.5mg/ml)取上液 0.2ml+生理盐水至1ml;(0.5mg/ml)(500ug/ml)皮试时取0.1ml(即 50ug/0.1ml)皮试结果判断同青霉素。美洛西林舒巴坦钠1.25g/瓶以上所需药物加生理盐水溶解至5ml;(250mg/ml)取上液 0.1ml+生理盐水至1ml;(25mg/ml)取上液 0.1ml+生理盐水至1ml;(2.5mg/ml)取上液 0.2ml+生理盐水至1ml;(0.5mg/ml)取上液 0.1ml 作皮试(即0.05mg)
3、皮试结果判断同青霉素。长效青霉素皮试液的配制方法长效青霉素1 瓶 120 万 u,注入 4ml 生理盐水,则 1ml 含 30 万 u 8 1?取 0.1ml l 含 3 万 u,作画痕试验。普鲁卡因皮试液配制方法普鲁卡因40mg/支,浓度为0.25%;取 0.125ml+生理盐水至1ml;取上液 0.1ml 作皮试(即0.25mg)皮试结果判断同青霉素。破伤风抗毒素(TAT)皮试液配制方法1500 U/支:取上液 0.1ml+生理盐水至1ml;(150U/ml)取上液0.1ml 作皮试;(即 15U)20 分钟观察结果,如为阴性可一次性注射,如为阳性者,则行脱敏疗法。阴性:局部无红肿、无异常
4、反应。阳性:皮丘红肿,硬结直径大于1.5cm,红晕范围直径超过4cm,有时出现伪足或有痒感,全身过敏性反应同青霉素过敏反应大致相同。脱敏疗法方法:第一次:取TAT0.1ml+生理盐水至1ml 肌肉注射;第二次:取TAT0.2ml+生理盐水至1ml 肌肉注射;.精选范本第三次:取TAT0.3ml+生理盐水至1ml 肌肉注射;第四次:取余液+生理盐水至1ml 肌肉注射。每隔 20 分钟注射一次,在脱敏过程中密切观察病人的反应。如病人有气促、面色苍白、紫绀、荨麻疹及头晕、心跳等不适时,应即停止注射并从速处理并报告医生。细胞色素C 皮试液的配制方法取细胞色素C 0.1ml+生理盐水至1ml;(0.75
5、mg/ml)取上液0.1ml 作皮试(即0.07mg)局部红肿,直径大于1cm,有丘疹者为阳性结核菌素50U/支/ml 取上液 0.1ml 作皮试(5U/ml)皮试时于左手注入试敏液,右手注入生理盐水作对照。48-72小时观察结果阴性:皮肤硬结小于5mm;阳性:皮肤硬结5-10mm(+),皮肤硬结10-15mm(+),皮肤硬结15-20mm(+),皮肤硬结大于20mm 或局部出现水疱或坏死者为(+),应向病人解释结素试验阳性仅表明曾有结核普鲁卡因皮试液配制方法普鲁卡因40mg/支,浓度为0.25%;取 0.125ml+生理盐水至1ml;取上液0.1ml 作皮试(即0.25mg)皮试结果判断同青
6、霉素。链霉素皮试液配制方法1g(100 万 U/瓶)链霉素 100 万 U+生理盐水至3.5ml(共 4ml)(25 万 U/ml)取上液 0.1ml+生理盐水至1ml;(2.5 万 U/ml)取上液 0.1ml+生理盐水至1ml;(2500 万 U/ml)取上液 0.1ml 作皮试(即2500U)(皮试结果判断同青霉素。链霉素过敏性休克抢救措施同青霉素过敏性休克抢救措施,因链霉素可与钙离子铬合,从而使链霉素的毒性症状减轻或消失。故需备10%葡萄糖酸钙注射液静脉注射)碘过敏试验:(30%泛影葡胺)(凡是造影者须做该试验)A、取 60%泛影葡胺(欧乃派克)0.5ml 加生理盐水至1ml 缓慢静脉
7、注射。B、专用 30%泛影葡胺试敏剂(1ml)缓慢静脉注射。密切观察15 分钟。如病人有恶心、呕吐、手足麻木感和(或)出现荨麻疹者即为阳性反应。青霉素过敏试验法:1、评估:1)仔细询问过敏史,如有青霉素过敏史则停止该项试验。有其他药物过敏史或变态反应疾病史应慎用。2)曾使用青霉素,停药 3 天(TAT7 天)后再次使用,或在使用过程中改不同批号的制剂时,需要重做皮试,确定结果为阴性才能继续用药。2、计划:1)用物准备:必需备0.1%盐酸肾上腺素,(其他略)2)病人准备:A、病人不宜空腹进行皮试,因个别人于空腹时注射用药会发生眩晕、恶心等反应,宜与过敏反应相混淆。文档编码:CX2M9D2D9O3
8、 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7
9、F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3
10、 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7
11、F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3
12、 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7
13、F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3
14、 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8.精选范本B、让病人了解注射目的,懂得观察期间不可随意离开;不可搔抓或揉按皮试局部;如有异常随时告知医护人员。3、实施:1)配制方法(略)2)皮内试验:于前臂内侧皮内注射皮试液0.1ml,20 分钟后观察皮试结果。皮试结果判断标准:阴性:皮丘无改变,周围不红肿,无红晕、无自觉症状。阳性:皮丘隆起增大,出现红晕,直径大于1cm,周围有伪足伴局部痒感;严重时可有头晕、心慌、恶心,甚至发生过敏性
15、休克。3)皮试结果阳性者不可使用青霉素,并要在病历、医嘱单、床头卡和注射单上加以注明,以及将结果告知病人及其家属。如对皮试结果有怀疑的,应在对侧前臂内注射生理盐水0.1ml,以作对照,确认青霉素皮试结果为阴性方可用药。过敏性休克的急救措施:1、立即停药,使病人平卧。2、立即皮下注射0.1%肾上腺素 1ml,小儿酌减。症状如不缓解,可每隔半小时皮下或静脉注射该药0.5ml。直至脱离危险期。3、给予氧气吸入,改善缺氧症状。呼吸受抑制时,应立即进行人工呼吸,并使用呼吸兴奋剂。喉头水肿引致窒息时,应尽快实行气管切开。4、根据医嘱静脉注射地塞米松5-10mg,应用抗组胺类药,如盐酸异丙嗪等。5、静脉滴注
16、10%葡萄糖溶液或平衡液扩充血容量。血压仍不回升,可按医嘱加入多巴胺等。6、若心跳骤停,则立即进行复苏抢救。7、密切观察病情,记录病人呼吸、脉搏、血压、神志和尿量等变化。文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O
17、3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G
18、7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O
19、3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G
20、7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O
21、3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8文档编码:CX2M9D2D9O3 HP3F8M6E8P7 ZE1R3G7F8H8