经纤维支气管镜灌注纤维蛋白原、凝血酶治疗咯血的疗效观察

An Observation of the effectiveness in the Treatment of Hemoptysis by Fibrinogen and Thrombin via Bronchoscopy

目的 旨在为临床治疗咯血寻求更有效的方法及药物,方法 将83例患者随机分成4组,组1经纤维支气管镜(FB)局部灌注纤维蛋白原+凝血酶;组2经FB局部灌注凝血酶;组3予垂体后叶素+常规止血药(止血敏、止血芳酸)静脉滴注;组4予常规止血药静脉滴注。结果 统计学检验显示,4种治疗方法疗效差别有显著性(P=0.0001)。组1、组2的治疗方法优于组3、组4(P<0.05)。而组1较组2疗效更优(P=0.05)。结论 经FB局部灌注凝血药物的止血效果优于静脉用药;经FB灌注纤维蛋白原+凝血酶比单用凝血酶的止血效果更显著。

OBJECTIVE: To search and study a more effective and convenient method in the treatment of hemoptysis. METHOD: 83 cases divided into 4 groups randomly, Gr. 1 fibrinogen and thrombin infused via bronchoscopy; Gr.2 thrombin infused only. Gr.3 vasopressin and antifibrinolysins(PAM-BA and AMCHA) used intravenously. Gr.4 Only antifibinogens(PAMBA and AMCHA) used. RESULT: The treatment effect among the four groups had significant difference statistically ( P = 0.0001) . The treatment effect of Gr. 1 and Gr. 2 was better than that of Gr. 3 and Gr. 4. (P<0.05). The treatment effect of Gr. 1 was better than that of Gr. 2 (P = 0.05). RESULT: The combination of fibrinogen and thrombin used via bronchoscopy ia an effective method in the treatment of hemoptysis, it is better than single drug used.