消痔灵注射液治疗颊部血管痣致三氯叔丁醇中毒

Chlorabutanol poisoning due to Xiaozhiling injection for treatment of vascular nevus on cheek

消痔灵注射液(含少量三氯叔丁醇)主要用于痔的治疗。1例32岁女性患者因右颊部血管痣局部注射消痔灵注射液,首次注射消痔灵10 ml后无不适,1周后再次注射15 ml,随即出现头晕、胸闷、恶心、呕吐,并出现心动过速,血压降低,呼吸窘迫,呕血。查体:P 181次/min,R 40次/min,BP 56/39 mm Hg,实验室检测:WBC 15.38×109/L,N 0.924,PLT80×109/L,PT17.7 s,PTA54.1%,AST55 U/L,TBil 22μmol/L,DBil 2μmol/L,GLU16.8 mmol/L,LDH683 U/L,ALB 22 g/L,胸片见双肺野斑片状模糊影,血气分析示Ⅰ型呼吸衰竭,血、尿检测示三氯叔丁醇浓度分别为920、854 ng/ml。经对症治疗,患者血、尿三氯叔丁醇浓度分别降至280、130 ng/ml,血常规、肝肾功能、胸部CT检查结果均恢复正常。

Xiaozhiling injection （containing a small amount of ehlorabutanol） is mainly used for treatment of hemorrhoid. A 32-years-old woman received local injection of Xiaozhiling for vascular nevus on her right check. The patient had no discomfort after the first injection of Xiaozhiling 10 ml. One week later, after the second injection of Xiaozhiling 15 ml, she developed dizziness, chest distress, nausea, vomiting, and then tachycardia, decreased blood pressure, respiratory distress, and hematemesis. An examination showed a pulse rate of 181 beats/min, a respiration rate of 40 breaths/min, a BP of 56/39 mmHg. Laboratory test revealed the following values： WBC count 15.38 × 10^9/L, N 0. 924, PLT count 80 × 10^9/L, PT 17.7 s, PTA 54. 1% , AST 55 U/L, TBil 22μmol/L, DBil 2 μmol/L, GLU 16.8 mmol/L, LDH 683 U/L, ALB 22 g/L, Chest X-ray revealed a flaky nubilous shadow in the lungs. Blood gas analysis showed type I respiratory failure. Blood and urine tests revealed a chlorobutamol level of 920 ng/ml and of 854 ng/ml, respectively. After symptomatic treatment, blood and urine chlorobutamol levels decreased to 280 ng/ml and 130 ng/ml, respectively. The results of routine blood test, liver and renal function tests, and a chest CT scan returned to within normal ranges.