1例13岁女性患儿,静脉滴注盐酸万古霉素,1次1 g,1日2次;给药50 min时,出现面色潮红,颈部轻微发红,血压(收缩压/舒张压)降至65/35 mm Hg(1 mm Hg=0.133 kPa),心率增快(133次/min),呼吸频率增快,经皮氧饱和度降至85％;立即停用盐酸万古霉素、更换输液通道后,经皮氧饱和度回升至95％及以上,血压恢复正常,面色潮红渐退.该患儿无既往过敏史或相关药品不良反应史,其面色潮红、心率增快及呼吸频率增快等症状与文献报道的1例成人缓慢注射万古霉素后发生红人综合征的案例相似.与过敏反应不同,万古霉素在儿童体内可能诱导组胺释放而致红人综合征.故应实时监测万古霉素血药浓度,注意降低输注速度.%A 13-year-old female patient was given intravenous drip of vancomycin hydrochloride once 1 g for twice a day, at 50 min after administration, the patient developed flushed complexion and neck, with blood pressure (systolic/diastolic) decreased to 65/35 mm Hg (1 mm Hg=0.133 kPa), heart rate increased (133 times/min), respiratory rate increased, percutaneous oxygen saturation decreased to 85％; the patient was given drug withdrawal of vancomycin hydrochloride and replacement of infusion channel immediately, then the percutaneous oxygen saturation rose back to 95％ and above, the blood pressure returned to normal, and the flushed complexion was faded. The child had no history of allergies or related adverse drug reactions, the symptoms of flushed complexion, heart rate and respiratory rate increased were similar to those reported in the literature for a case of red-man syndrome after slow injection of vancomycin in adults. Unlike allergic reactions, vancomycin may induce histamine release in children and cause red-man syndrome. Therefore, the blood concentration of vancomycin should be monitored in real time, and the infusion rate should be reduced.
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