纤维支气管镜对不明原因咯血的诊治价值及安全性评价

Value and safety of bronchofibroscopy in diagnosis and treatment of hemoptysis--attached analysis of bronchofibroscopy in 335 Hemoptysis Patients

目的评价纤维支气管镜对不明原因咯血的诊治价值及安全性。方法对335例影像学检查阴性且原因不明的咯血患者行纤维支气管镜检查,并予镜下局部止血治疗。结果发现炎症为主要的咯血病因,占55.8%,其次为结核15.8%肺癌14.3%。诊断阳性率为86%。镜下发现有活动性出血164例,镜下局部综合止血治疗后显效者141例,有效者18例,无效者为大咯血5例,有效率为97%。并发喉痉挛或支气管痉挛者2例;严重低氧血症(SaO2<80%)1例。结论纤维支气管镜检查是原因不明的少中量咯血患者必要且安全的有创检查之一。

Objective] To evaluate the value and safety of bronchofibroscopy in diagnosis and treatment of hemoptysis. [Methods] 335 patients whose reasons for hemoptysis were not kown by cheat X-ray or HRCT were all toke with bronchofibroscopy , but nothing was found. Bronchofibroscopy were performed in them. [Result] Infection was main cause of hemoptysis and the percentage was 55.8%. Tubercolosis was the second cause of hemoptysis and the percentage was 15.8%. Lung cancer was the third cause and the percentage was 14.3%. 86% of the patients were diagnosised. Clearly active bleeding was found in 164 patients. Local hemostasis treatment was excellent in 141 patients, effective in 18 patients and ineffective in 5 patients with severe hemoptysis. The effective rate of treatment is 97%. The complications of bronchofibroscopy were minor. Two patients suffered from laryngospasm and bronchospasm. One patient suffered from severe hypoxemia (SaO2<80%). [Conclusion] Bronchofibroscopy is one of the safe and effective ways in the diagnosis of slight to moderate hemoptysis.