86例大咯血急诊肺切除术临床分析

Emergency pneumonectomy for massive hemoptysis: a clinical analysis of 86 cases

目的探讨因大咯血施行急诊肺切除术的临床特点及疗效。方法对86例因大咯血施行急诊肺切除的患者资料进行分析。结果大咯血病因以肺结核、支气管扩张、曲菌病等病因为主。本组治疗有效率100%,术后并发症12例,发生率13.95%,无死亡病例。结论大咯血患者在出血部位确定,病变局限;有咯血引起窒息先兆、窒息或低血压时应行急诊手术,手术以肺叶切除为主,止血效果好,临床疗效满意。加强术中残端处理及术后治疗管理,有望降低急诊手术的并发症和死亡率。

Objective To evaluate the clinical characteristics and therapeutic effect of operation of emergency pneumonectomy for massive hemoptysis.Methods Retrospectively analyzed the clinical dates of 86 cases with massive hemoptysis′ treated by emergency operations in our hospital.Results The main etiologies are tuberculosis,bronchiectasis and aspergillosis.All patients survived and incidence of postoperative complications was 12 cases（13.95%）.Conclusions The surgery for massive hemoptysis cases should be operated as early as possible,to patients with limited bleeding extent and accurate bleeding site;or have the dangerous to develop into asphyxia,premonition of asphyxia,or hypotension by hemoptysis;As well as to patients who suffered blood loss anemia by repeatedly hemoptysis.lobectomy is preferred.Moreover,Deal with the stump of bronchi properly in operation and strengthen postoperative management have the tendency to reduce the complications and mortality rate of the operation.