咯血诊治临床路径

Clinical pathway for diagnosis and treatment of hemoptysis

目的探讨咯血诊断治疗临床路径化策略。方法回顾性分析解放军252医院呼吸科2004年1月至2013年1月以咯血为入院诊断的293例病例，归纳、总结咯血的诊断与治疗，对比病因已明咯血与病因未明咯血的临床特点。结果确定病因204例，不明病因89例，经内科与支气管动脉栓塞治疗292例成功止血，1例死亡。不明原因占30．4％，其中大咯血所占比例高于已明原因（x^2=8．79，P〈0．05）。结论采取恰当咯血诊断治疗临床路径，有利于咯血诊治。

Objective To study the clinical pathway for the diagnosis and treatment of hemoptysis. Methods From January 2004 to January 2013, the clinical data of 293 cases of hemoptysis hospitalized were retrospectively analyzed. The clinical features between definite diagnosis and indefinite diagnosis were compared. Results Out of the 293 cases, definite diagnosis was eventually achieved in 204 patients, indefinite diagnosis had been made in 89 cases. Hemoptysis was controlled in 292 patients by bronchial artery enbolization and conservative treatment. One case died. Massive hemoptysis rate of indefinite diagnosis was significantly higher than that of definite diagnosis （ X2= 8.79, P 〈0.05）. Conclusions The effective clinical pathway for the diagnosis and treatment of hemoptysis can improve success rate of treatment for hemoptysis.