乙酰半胱氨酸致咯血1例

One case of hemoptysis induced by acetylcysteine

1例68岁女性患者因“反复咳嗽、咳痰30余年,再发伴咯血2d”入院,临床诊断为支气管扩张伴咯血,慢性肠炎,阑尾切除术后。入院后给予止血、化痰、抗感染等治疗。第3天咯血停止,次日停用所有止血药。第6天患者主诉痰液极难咳出,晚间加用乙酰半胱氨酸泡腾片(0.6g,qn)辅助化痰。用药约2h后,患者发生咯血,量约10mL,色鲜红,遂自行停药,次日咯血停止。第9天患者出院。一周后随访,患者曾于出院后第4天按原剂量服用乙酰半胱氨酸泡腾片,约3h后再次出现咯血,量约5mL,色鲜红,自行停用后,患者未再发生咯血。

A 68-year-old female patient was admitted to the hospital because of repeated cough and expectoration for more than 30 years and hemoptysis for 2 days. The clinical diagnosis were bronchiectasis with hemoptysis, chronic enteritis and postoperative appendectomy. After admission, systemic treatments including stopping bleeding, eliminating phlegm and antiinfection were given to her. On the 3rd day, the hemoptysis was stopped and all hemostatic drugs were stopped on the next day. On the 6th day, the patient complained that the sputum was extremely difficult to expectorate and acetylcysteine effervescent tablets (0.6 g, qn) were given to the patient at that night. Two hours later, the patient expectorated about 10 mL bright red blood and acetylcysteine was immediately stopped by herself. Hemoptysis stopped on the next day. The patient was discharged on 9th day. Follow-up results after one week showed that she took 0.6 g acetylcysteine effervescent tablets on the 4th day after discharge and expectorated 5 mL bright red blood about 3 hours later. There was no hemoptysis after the withdrawl of acetylcysteine effervescent tablets.