40例大咯血临床分析  

Clinical analysis of 40 cases of massive hemoptysis

作　　者：苗彦[1,2] 林棱[2] 吴少杰[3] MIAO Yan;LIN Leng;WU Shao-Jie(Shengli Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;Department of Internal Medicine,South Branch of Fujian Provincial Hospital,Fuzhou 350028,China;Department of Interventional Radiology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福州350001 [2]福建省立医院南院内科,福州350028 [3]福建省立医院介入放射科,福州350001

出　　处：《创伤与急诊电子杂志》2019年第3期130-134,共5页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的分析大咯血的临床诊治特点,提高对大咯血认识。方法回顾性分析本院2013年10月至2019年5月收治的40例大咯血患者的临床资料,包括性别、年龄、临床表现、影像学检查、实验室检查及治疗方案等信息。结果40例大咯血患者首次咯血21例,咯血后意识障碍5例,呼吸衰竭16例(Ⅰ型呼吸衰竭12例,Ⅱ型呼吸衰竭4例),休克5例。病因分析中感染性疾病17例(其中支气管扩张伴感染12例),血管疾病16例,肿瘤性疾病4例,医源性操作2例,不明原因咯血1例。治疗方面,药物治疗12例,支气管动脉介入栓塞治疗28例,介入栓塞失败转外科手术治疗1例,最后好转36例,死亡4例。结论大咯血为呼吸科急危重症,死亡率高,支气管动脉栓塞术治疗大咯血疗效好,不良反应少,可作为一线治疗方法。Objective To analyze the clinical diagnosis and treatment of massive hemoptysis and improve the understanding of massive hemoptysis.Methods The clinical data of 40 patients with severe hemoptysis admitted to our hospital from October 2013 to May 2019 were retrospectively analyzed,including gender,age,clinical manifestations,imaging examination,laboratory examination and treatment plan.Results Among 40 patients with severe hemoptysis,21 cases were the first-time hemoptysis,5 cases were disturbance of consciousness after hemoptysis,16 cases were respiratory failure including 12 cases of type Ⅰ respiratory failure and 4 cases of type Ⅱ respiratory failure,and 5 cases were shock.The etiological analysis showed that 17 cases were infectious disease including 12 cases of bronchiectasis accompanied by infections,16 cases of vascular diseases,4 cases of neoplastic diseases,2 cases of iatrogenic operation,and 1 case of unexplained hemoptysis.In terms of treatment,12 cases were treated with drugs;28 cases were treated with bronchial artery embolization;1 case was transferred to surgery after the failure of embolization;36 cases got better and 4 cases died.Conclusion Massive hemoptysis is an acute and severe disease of the respiratory system with a high mortality rate.Bronchial artery embolization has good effects and few adverse reactions in treating massive hemoptysis.Thus,it is considered to be a good alternative in the clinical practice.

关 键 词：大咯血 临床 分析 

分 类 号：R56[医药卫生—呼吸系统]