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对儿童对胺组局部麻醉剂的直接类型过敏反应的诊断测试的评估
Sinem Aslan1, Hülya Anıl1, Muhammet Kaya1
1Department of Pediatric Allergy and Immunology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
概括
在儿童中诊断局部麻醉剂 (LA) 过敏可以有效地通过连续的皮肤刺伤测试, 1:10稀释的皮内测试 (IDT) 和皮下挑来实现. 这种可靠的策略即使在怀疑过敏反应时也有效.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 儿科牙科 儿科牙科
- 药理学 药理学是指药理学的学科.
背景情况:
- 局部麻醉 (LAs) 在儿科牙科手术中对疼痛管理至关重要.
- 虽然疑似过敏很常见,但确诊的LAs直接型过敏症很少见.
- 建立对儿童LA过敏的可靠诊断方案至关重要.
研究的目的:
- 定义一个最佳的诊断方案,用于儿童立即类型局部麻醉剂过敏.
- 评估一种替代诊断方法的实用性和可靠性,用于胺类型局部麻醉剂过敏性测试.
主要方法:
- 88名儿科患者的回顾性审查,怀疑LAs的立即类型反应.
- 连续过敏测试:皮肤刺伤测试 (SPT),然后以 1:10 的稀释进行皮内测试 (IDT),如果 SPT 呈阴性.
- 如果SPT和IDT均为阴性,则进行皮下挑试验.
主要成果:
- 大多数可疑的LAs (67%) 是未确定的;最常见的是阿尔蒂卡因和利多卡因.
- 皮内检测 (IDT) 在12.5%的患者中呈阳性,鉴定出阿提卡因,普罗卡因和利多卡因是触发因素.
- 在1:10稀释的IDT显示了高负预测值 (99%) 立即类型的反应.
结论:
- 涉及SPT的诊断策略,其次是1:10稀释的IDT,然后是皮下挑,是时间高效和可靠的.
- 该方案适用于诊断直接类型的LA过敏,包括有过敏反应史的病例.
- 这种诊断方法对于在儿童中对胺类局部麻醉剂过敏的识别是实用的和可靠的.
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