气管镜介入诊疗大出血危险因素分析

Risk factors for massive hemorrhage in bronchoscopy

目的分析气管镜介入相关诊疗并发大出血的危险因素。方法选择2011年12月-2012年12月解放军总医院呼吸科介入肺脏病中心经气管镜诊治的患者113例。按照气管镜检查时出血量的多少分为出血组和对照组。出血组定义为出血量>100 ml,其中出血量>300 ml定义为大出血;对照组为出血量<100 ml。记录患者的各种临床指标、活检情况与病理诊断结果。结果两组年龄和乙肝、丙肝病毒感染阳性率差异有统计学意义(P<0.05),余指标差异无统计学意义(P>0.05)。但是出血量>300 ml的大出血组,曲霉菌感染和血管瘤是导致大出血的最危险病因。结论应警惕非恶性肿瘤患者活检时出血,尤其是曲霉菌感染和血管瘤。要严格气管镜的活检指征,降低大出血的发生率。

Objective To analyze the risk factors for massive hemorrhage in bronchoscopy. Methods One hundred and thirteen patients who underwent bronchoscopy in our hospital from December 2011 to December 2012 were divided into hemorrhage group （blood loss 〉 100 ml） and control group （blood loss 〈 100 ml）. Blood loss 〉 300 ml was considered as massive hemorrhage. Their clinical indicators, biopsy findings, and pathological diagnosis were recorded. Results The age and positive rate of hepatitis B or C virus infection were significantly different between the two groups （P 〈 0.05）; while no significant difference found in the other indications （P 〉 0.05）. Aspergillus infection and hemangioma were the most significant risk factors for massive hemorrhage when the blood loss was 〉 300 ml. Conclusion Hemorrhage should be seriously considered in biopsy of non-malignant tumor patients especially with Aspergillus infection and hemangioma. Strict control of biopsy indications for bronchoscopy can reduce the occurrence of massive hemorrhage.