中国药物警戒 ›› 2025, Vol. 22 ›› Issue (10): 1168-1170.
DOI: 10.19803/j.1672-8629.20241000

• 安全与合理用药 • 上一篇    下一篇

吸入用乙酰半胱氨酸溶液致急性喉头水肿1例分析

袁梦1, 魏春燕1, 陈瑶2,*   

  1. 1四川大学华西医院临床药学部,四川 成都 610041;
    2四川大学华西医院重症监护科,四川 成都 610041
  • 收稿日期:2024-12-18 出版日期:2025-10-15 发布日期:2025-10-20
  • 通讯作者: *陈瑶,女,博士,重症医学。E-mail: 3143518595@qq.com
  • 作者简介:袁梦,女,硕士,临床药学。

One Case of Acute Laryngeal Edema Caused by Acetylcysteine Solution for Inhalation

YUAN Meng1, WEI Chunyan1, CHEN Yao2,*   

  1. 1Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu Sichuan 610041, China;
    2Intensive Care Unit, West China Hospital, Sichuan University, Chengdu Sichuan 610041, China
  • Received:2024-12-18 Online:2025-10-15 Published:2025-10-20

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摘要： 目的 探讨吸入用乙酰半胱氨酸溶液引起急性喉头水肿的临床特征、判断方法和治疗策略,为临床安全用药提供参考。方法 分析1例雾化吸入乙酰半胱氨酸溶液致急性喉头水肿的病例,归纳总结相关处理方案。结果 患者因腹主动脉瘤覆膜支架植入术后内漏,在雾化吸入乙酰半胱氨酸溶液1 h 47 min后,出现急性喉头水肿,临床表现为呼吸困难、声音嘶哑。鉴于症状与乙酰半胱氨酸已知不良反应症状和雾化使用时间的高度相关性,故怀疑是该药致急性喉头水肿,随即停用该药并予肾上腺素,患者症状缓解,生命体征平稳。结论 应注意吸入用乙酰半胱氨酸溶液的急性喉头水肿风险,其特点是有发病快、危及生命,应加强观察,综合判断,及时停药,必要时予肾上腺素治疗。

关键词: 乙酰半胱氨酸, 吸入用, 过敏反应, 急性喉头水肿, 药品不良反应

Abstract: Objective To analyze the clinical characteristics of acute laryngeal edema induced by inhalation of acetylcysteine solution and to devise corresponding diagnostic approaches and therapeutic strategies in order to provide evidence-based references for safe medications. Methods One clinical case that presented with acute laryngeal edema following inhalation of acetylcysteine solution administration was analyzed before management protocols were formulated based on literature and evidence. Results A patient was treated for endoleaks in a stented abdominal aortic aneurysm. One hour and 47 minutes after acetylcysteine inhalation, the patient developed acute laryngeal edema, with clinical manifestations of dyspnea and hoarseness. The temporal correlation between drug administration and the symptom onset strongly suggested acute laryngeal edema due to acetylcysteine solution. Immediate discontinuation of the suspected agent combined with adrenaline therapy resulted in complete resolution of clinical manifestations and stabilization of vital signs. Conclusion Clinicians should remain vigilant against the risk of acute laryngeal edema associated with inhalation of acetylcysteine solution. This condition has a rapid onset and is potentially life-threatening. Enhanced clinical monitoring, comprehensive assessment, prompt withdrawal of suspected agents and adrenaline therapy when necessary are crucial to optimizing patient outcomes.

Key words: Acetylcysteine, Inhalation, Anaphylaxis, Acute Laryngeal Edema, Adverse Drug Reactions

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