乙酰半胱氨酸注射液致血管性水肿1例分析

目的探讨乙酰半胱氨酸注射液致血管性水肿的原因及治疗方法。方法分析吉林大学第一医院血管外科2018年9月收治的1例动脉硬化闭塞症患者因注射乙酰半胱氨酸注射液致血管性水肿的可能性及治疗方法。结果 1例65岁女性患者因左下肢发凉、麻木、疼痛1年入院。入院第1天给予乙酰半胱氨酸注射液8 g+5%葡萄糖溶液250 mL静脉滴注,注射该药后约1小时20分钟,患者出现面部水肿、全身皮疹等血管性水肿症状,立即停药并给予抗过敏治疗,对症治疗后1 h患者上述症状消失,入院第14天病情好转出院。结论乙酰半胱氨酸注射液很可能引起该患者血管性水肿。注射该药物时应注意减小滴速,谨慎用于有药物过敏史、哮喘的患者,同时注射时应有专人陪护并注意观察。

One Case of Angioedema Induced by Acetylcysteine Injection

Objective To investigate the causes of and solutions to angioedema induced by acetylcysteine injection. Methods The possibility of and solutions to angioedema caused by acetylcysteine injection were analyzed in one patient with arteriosclerosis obliterans admitted to the Department of Vascular Surgery of the First Hospital of Jilin University in September 2018. Results A 65-year-old female patient was admitted to the hospital because her left lower limb had felt cold, numb and hurt for a year.On the first day after admission, the patient was intravenously given 8 g acetylcysteine along with 250 mL 5% glucose.After eighty minutes, such symptoms of angioedema appeared as facial edema and systemic rash.Medication was discontinued right away and antiallergic treatment was offered.The above symptoms disappeared after one hour of symptomatic treatment. On the 14 th day, the patient got better and was discharged. Conclusion Acetylcysteine injection might have caused angioedema in this patient. Dripping has to be slow while this drug is injected, and it should be used with caution among patients with a history of drug allergy and asthma. At the same time, the patient has to be attended to and observed closely.