127例咯血患者支气管镜检查及镜下治疗分析  

The Clinical Analysis of the Treatment of Bronchoscopy for 127 Cases of Hemoptysis

作　　者：罗世林[1] 周江[1] 张仕国[1] 毛淑华[1] 

机构地区：[1]巴中市中心医院呼吸内科,四川巴中636000

出　　处：《四川医学》2014年第3期373-375,共3页Sichuan Medical Journal

摘　　要：目的评价支气管镜检查和(或)治疗咯血患者价值及风险。方法回顾性分析127例咯血患者,经支气管镜下治疗前病因明确患者85例,给予生理盐水局部冲洗,后给予冰去甲肾上腺素1ml+血凝酶1KU局部喷洒治疗。经支气管镜下检查及治疗前病因不明确患者42例,先行活检及刷检检查,后给予止血治疗(止血方法同上)。结果 127例患者经支气管镜检查和(或)治疗后,病因明确患者104例,止血治疗有效者100例(96.2%)。病因未明确者23例,止血有效患者19例(82.6%);4例患者止血治疗无效,其中出现大咯血2例,抢救成功1例,死亡1例。支气管镜下治疗前85例病因明确患者镜下止血治疗有效者83例,有效率97.6%;支气管镜检查及治疗前42例病因不明确患者,镜下止血有效者36例,有效率85.7%,两者比较,差异有统计学意义(P<0.05)。结论咯血患者支气管镜检查能够较好的明确病因,支气管镜下治疗咯血疗效好,病因明确者疗效更佳,病因不明确咯血患者支气管镜检查及治疗存在高风险。Objective To estimate the diagnostic and therapeutical value and the risk of the bronchoscopy for hemoptysis. Methods 127 patients of hemoptysis, consist of 85 patients who had explicit pathogenesis and the other 42 cases of equivocal pathogenesis, were undergo bronchoseopy. The diseased region of the 85 patients, who had explicit diagnosis, were flushed by NS and then sprayed by frozen noradrenaline 1 ml and hemocoagulase 1KU. The 42 patients of acataleptic diagnosis were accepted the equal treatment of hemostasis behind the biopsy and brush biopsy. Results After the bronehoscopy, the diagnosis of 104 pa- tients were clarified, in which 100 cases （96.2%） were stanched effectively, and 19 cases （82.6%） of the 23 agnogenic patients were effectively threated too. In the 4 patients of treatment -resisted, massive hemoptysis occurred in 2 patients in the inspection process, and one of them died despite all treatment. 83 cases of the 85 patients of explicit diagnosis before the bronchoscopy were stanched, with the effective rate of 97.6% ;and 36 cases of 42 patients of acataleptic diagnosis before the bronchoscopy were stanched, with the effective rate of 85.7%, both comparative difference of the the effective rate was statistically significant（P 〈 0. 05）. Conclusion The bronchoscopy could help to identify the pathogenesis of the hemoptysis efficiently. The bronchoscopy was therapeutic for hemoptysis which pathogenesis was recognised, but high-risked for which pathogenesis was acataleptic.

关 键 词：咯血 支气管镜 检查 治疗 

分 类 号：R562.2[医药卫生—呼吸系统]