肺动脉高压合并肺部疾病患者的临床特征及支气管镜下表现及安全性分析  

Clinical features,findings and safety of bronchoscopy in patients with pulmonary hypertension and pulmonary disease

作　　者：陶梅梅 李菲[1] 高杨[1] 朱光发[1] TAO Meimei;LI Fei;GAO Yang;ZHU Guangfa(Department of Pulmonary and Critical Care Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所呼吸及危重症医疗科,100029

出　　处：《心肺血管病杂志》2024年第6期599-604,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析肺动脉高压(pulmonary hypertension,PH)合并肺部疾病患者的临床特征、支气管镜下表现及安全性。方法:回顾性分析PH合并肺部疾病患者28例,对其临床特点、支气管镜下表现及安全性进行总结。结果:在28例患者中,9例为动脉性,10例为肺部疾病和/或低氧所致,4例为慢性血栓栓塞性;5例为纤维性纵隔炎。超声心动示平均肺动脉收缩压为(64.6±22.8)mmHg(1mmHg=0.133kPa),16(57.1%)例患者行右心导管检查,平均肺动脉压为(41.2±12.5)mmHg。所有28例患者均行支气管肺泡灌洗,3例行经支气管黏膜活检,6例行经支气管肺活检,2例行预置止血球囊联合经支气管冷冻肺活检,5例行超声支气管镜引导下的经支气管镜针吸活检。均无大出血、低血压及气胸情况发生,13例患者术中出现低氧血症。结论:PH患者可以在镇静下行支气管镜检查,但需要注意术前评估肺动脉压力及改善心功能。Objective:To analyze the clinical characteristics,findings and safety of bronchoscopy in patients with pulmonary hypertension and pulmonary disease.Methods:Totally 28 inpatients with pulmonary hypertension and pulmonary disease were retrospectively selected.The clinical characteristics,findings and safety of bronchoscopy were analyzed.Results:Among the 28 patients,9 were pulmonary arterial hypertension,10 were pulmonary disease and/or hypoxia induced PH,4 were chronic thromboembolic pulmonary hypertension,and 5 were fibrous mediastinitis.Echocardiography showed an average pulmonary artery systolic pressure of(64.6±22.8)mmHg(1mmHg=0.133kPa).The mPAP of(41.2±12.5)mmHg were detected in 16(57.1%)patients who accepted right heart catheterization.All 28 patients underwent bronchoalveolar lavage,3 underwent bronchial mucosal biopsy,6 underwent transbronchial lung biopsy,and 2 underwent pre-placed balloons combined with transbronchial cryobiopsy,and 5 underwent endobronchial ultrasound-guided transbronchial needle aspiration.No major bleeding,hypotension and pneumothorax occurred.13/28 patients experienced hypoxemia.Conclusions:It is safe to carry out bronchoscopy under sedation in patients with PH.It is important to evaluate preoperative pulmonary artery pressure and improvement of heart function.

关 键 词：肺动脉高压 支气管镜 安全性 

分 类 号：R54[医药卫生—心血管疾病]