经支气管镜冷冻取血栓治疗安全性及疗效分析

Analysis on safety and therapeutic efficacy of freezing and removing thrombus through bronchoscope

目的分析14例经支气管镜检查，冷冻方式取血栓治疗术后患者血栓清除的疗效及治疗安全性。方法选取14例咯血患者，支气管镜检查后明确气管、支气管腔内血栓形成，予以镜下冷冻取血栓，术中术后监测患者血氧饱和度、心率、血压、血白细胞、细菌培养的变化，同时对患者治疗好转率、咯血复发情况、术后肺部感染率、肺不张发生率、死亡率进行追踪及分析。结果患者经冷冻取血栓后支气管腔内血栓清除良好；治疗过程中有血压升高、心率加快、氧饱和度降低等不良反应，但无严重不良事件。术后有4例患者咯血加重，2例经一般治疗后咯血停止，2例行支气管动脉栓塞术后咯血停止，无一例死亡。结论经支气管镜冷冻取血栓术治疗血栓清除成功率高，术后仅有1例肺不张，无肺部感染等并发症，但安全性有待进一步探讨。

Objective To analyse the efficacy and safety of cryotherapy and thrombectomy through bronchoscopy. Methods 14 patients with hemoptysis were identified as tracheal and bronchial thrombosis by bronchoscopy,blood clots were frozen and taken through bronchoscope. The oxygen saturation, heart rate, blood pressure, white blood cells, and the change of the bacterial culture of patients during and after the peration were monitored. At the same time, the haemoptysis relapse, postoperative lung infection, atelectasis incidence, mortality rates of all the patients were analysed. Results The bronchial lumen thrombosis was successfully removed. There were high blood pressure, heart rate, reduction of oxygen saturation or other adverse reactions in the treatment process, with no serious adverse events. In four patients with hemoptysis aggravation, haemoptysis stopped in two cases after general treatment, hemoptysis stopped in two cases after the operation of bronchial artery embolization. No case died. Conclusions It has high success rate that cryotherapy and thrombectomy through bronchoscope. There are no postoperative complications such as pulmonary infection,only one case had pulmonary atelectasis. The security remains to be further discussed.