支气管扩张症并发原发性纤溶亢进2例报告

Bronchiectasis combined with primary hyperfibrinolysis:report of two cases

咯血是支气管扩张的常见并发症,但部分患者并发原发性纤溶亢进症非常罕见且易漏诊,按咯血常规止血治疗无效,容易延误病情致患者死亡。本文对2例支气管扩张并发原发性纤溶亢进症临床特征进行归纳分析。患者均有支气管扩张病反复间歇咯血史,此次入院皆有中等量以上咯血,经垂体加压素和云南白药等常规止血治疗疗效不佳。经实验室检查确诊原发性纤溶亢进症。予纤维蛋白原、冷沉淀输注及止血芳酸等对症治疗,维持纤维蛋白原在1.5 g/L以上,患者均好转出院。

Hemoptysis is a common complication of bronchiectasis,but concurrent primary hyperfibrolysis is very rare and easily gives rise to missed diagnosis.Patients with bronchiectasis complicated by primary hyperfibrolysis do not respond to regular treatment for hemoptysis,which may potential cause fatal consequences.We report two cases of bronchiectasis combined with primary hyperfibrinolysis.Both of the patients had a history of bronchiectasis and were admitted for intermittent hemoptysis.Conventional treatment such as vasopressin failed to produce a favorable response.The eventual definite diagnosis of primary hyperfibrinolysis was established based on laboratory examinations.After diagnosis,the patients received fibrinogen and cryoglobulin to maintain a fibrinogen level over 1.5 g/L.Both of the patients subsequently showed improved conditions and were discharged.