支气管动脉栓塞术后肺结核再咯血的综合治疗

Analysis of comprehensive treatment of pulmonary tuberculosis with massive hemoptysis after bronchial artery embolization(BAE)

目的探讨肺结核大咯血行支气管动脉栓塞术(BAE)后再次出现咯血的综合治疗方法。方法总结1997年8月至2006年2月间289例肺结核大咯血行BAE治疗失败后再次出现咯血的42例患者,根据咯血量的多少,采用不同的治疗措施,20例小量咯血应用云南白药和止血芳酸治疗,22例中至大量咯血患者联合应用蛇毒血凝素和人工冬眠治疗。结果20例小量咯血经云南白药和止血芳酸治疗后,有效止血率95.0%,22例中至大量咯血联合应用蛇毒血凝素和人工冬眠治疗,有效止血率为86.4%。结论肺结核大咯血行BAE后再次出现小量咯血可以采取常规治疗,中至大量咯血联合应用蛇毒血凝素和人工冬眠不失为有效的治疗手段。

Objective To evaluate the effectiveness of comprehensive treatment of pulmonary tuberculosis with massive hemoptysis after BAE. Methods The patients＇ outcome during 2nd hemoptysis after bronchial artery embolization （BAE） for pulmonary tuberculosis hemoptysis at outpatient clinic emergency were analyzed. Among 289 pulmonary tuberculosis massive hemoptysis patients, 42 had 2nd hemoptysis after BAE from Aug. 1997 to Feb. 2006.20 cases of small hemoptysis were treated with Yunnan White Drug powder and tranexamic acid and 22 cases of massive hemotysis were treated with hemocoagulase and artificial hibernation combined. Results The haemostatic rate of patients treated with Yunnan White Drug powder and tranexamic acid was 95.0 %, and hemocoagulase and artificial hibernation combination group was 86.4%. Conclusion Small hemoptysis during 2nd hemoptysis after bronchial artery embolization（BAE） for pulmonary tuberculosis may be treated regularly, but middle and massive hemoptysis can be more effectively treated with hemoeoagulase and artificial hibernation combined.