经纤支镜介入治疗咯血的疗效观察  

An Observation of the Effectiveness in the Treatment of Hemoptysis by Interventional Treatment Via Bronchoscopy

作　　者：吴苏武[1] 卢东生[1] 余天峰[1] 黄斌[1] 赵淑灿[1] 林茂煌[1] 

机构地区：[1]广东省汕头市中心医院内六科,广东汕头515031

出　　处：《河北医学》2005年第10期892-894,共3页Hebei Medicine

摘　　要：目的:旨在为临床治疗咯血寻求更有效的方法及药物.方法:将90例中、大量咯血患者随机分成3组.组1 (纤维蛋白原组) 用2%纤维蛋白原5 ml,经纤维支气管镜FB(Olympus P40)于出血部位局部灌注,继之用凝血酶1 000 U加5 mL生理盐水溶解后再灌注.组2 (凝血酶组) 用凝血酶1 000 U局部灌注 (方法同上).组3 (止血药物组) 用垂体后叶素5～10 U加入5 % GS或GNS 500 ml中,静脉点滴1～2次/d,同时给予常规止血药物止血敏2～3g,止血芳酸0.4～0.6g,加入补液中静脉点滴1次/d.组3治疗无效者可进入组1或组2.结果:统计学检验显示,3种治疗方法疗效差别有显著性(P=0.0001);组1、组2的治疗方法优于组3(P＜0.05﹚;而组1较组2疗效更优(P=0.05).结论:经纤维支气管镜 (FB)局部灌注凝血药物的止血效果优于静脉用药;经FB纤维蛋白原加凝血酶联合使用疗效优于单用凝血酶者.Objective： To search and study a more effective and convenient method in the treatment of hemoptysis. Method： 90 moderate and severe hemoptysis cases were divided into 3 groups randomly, Gr. 1 was infused with fibrinogen and thrombin via bronchoscopy ; Gr. 2 was infused with thrombin only. Gr. 3 was injected vasopressin and antifibrinolysins （ PAM - BA and AMCHA ） intravenously. Gr. 3 can enter Gr. 1 or Gr. 2 when the treatment was inefficient. Result： The treatment effect among the three groups had significant difference statistically （ P = 0 . 0001 ）. The treatment effect of Gr. 1 and Gr. 2 was better than that of Gr. 3 （ P 〈 0.05 ）. The treatment effect of Gr. 1 was better than that of Gr. 2 （ P = 0.05 ）. Conclusion： The combination of fibrinogen and thrombin used via bronchoscopy is an effective method in the treatment of hemoptysis, it is better than single drug used.

关 键 词：咯血 纤维支气管镜 介入治疗 纤维蛋白原 凝血酶 

分 类 号：R56[医药卫生—呼吸系统]