由于最初症状缓解后可能出现双相严重过敏反应或复发,应对住院患者进行监测。对于不同严重过敏反应患者,推荐的监测时间不等,可从最短的 4 至 6 小时,[55]Boyce JA, Assa'ad A, Burks AW, et al; NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010 Dec;126(suppl 6):S1-58.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241964/http://www.ncbi.nlm.nih.gov/pubmed/21134576?tool=bestpractice.com至重症病例的 24 小时或更多。[56]Kemp SF, Lockey RF, Simons FE; World Allergy Organization ad hoc Committee on Epinephrine in Anaphylaxis. Epinephrine: the drug of choice for anaphylaxis-a statement of the world allergy organization. World Allergy Organ J. 2008 Jul;1(suppl 7):S18-26.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666145/http://www.ncbi.nlm.nih.gov/pubmed/23282530?tool=bestpractice.com还未有关于观察期长短的差异、或其对于相关患者结局影响的研究。[57]National Institute for Health and Care Excellence. Anaphylaxis: assessment and referral after emergency treatment. Dec 2011 [internet publication].https://www.nice.org.uk/guidance/CG134
对治疗反应良好且症状在观察期间没有反弹的患者,可准予出院并密切随访,同时嘱咐其在重新出现症状时复诊。患者识别症状的能力以及肾上腺素的自我给药能力应影响这一决定。[60]Arnold JJ, Williams PM. Anaphylaxis: recognition and management. Am Fam Physician. 2011 Nov 15;84(10):1111-8.https://www.aafp.org/afp/2011/1115/p1111.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/22085665?tool=bestpractice.com患者应将病情告知其全科医生,并立即由一名过敏专科医师进行随访。