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1993年1月—1995年12月期间,我科经纤维支气管镜(纤支镜、欧林巴斯BF—1T_(10)型)注入凝血酶局部治疗咯血50例,止血效果迅速确切,现报道如下。 1 资料与方法 1、1 病例选择:选择咯血量每天大于100ml的住院病例共80例,随机分为经纤支镜注入组(简称治疗组)50例和常规药物联合治疗组(简称对照组)30例。治疗组男35例,女15例,年龄24—68岁,其中51岁以上21例,支气管扩张症25例,支气管炎14例,肺结核11例,大量咯血 (大于500ml/d)10例,中量咯血(200—500ml/d)22例,小量咯血(100—200ml/d)18例。对照组男18例,女12例,年龄22—72岁,其中51岁以上14例;支气管扩张症13例,支气管炎9例,肺结核8例;大量咯血6例,中量咯血14例,小量咯血10例。 1、2 方法:治疗组术前肌注阿托品0.5mg安定10mg,2％利多卡因作喉、鼻腔粘膜喷雾麻醉,在高流量鼻导管给氧和心电监护下,经鼻腔进镜,入声门裂后,经纤支镜吸引管注入2％利多卡因2ml麻醉气管、支气管粘膜,並吸出气管及支气管内的积血,探明出血部位,然后注入凝血酶液(2000—4000u溶于5ml的0.9％氯化钠溶液中)。对于中量及大量咯血的32例病人在探明出血部位后给予去甲肾上腺素2mg,在出血明显减少下注入凝血酶液4000u。对照组使用常规药物包括脑垂体后叶素、抗纤溶芳酸、
From January 1993 to December 1995, 50 cases of thrombolytic hemoptysis were injected with thrombin via bronchofiberscope (bronchofiberscope, Olympus BF-1T_ (10) type), and the hemostatic effect was prompt and definite as follows. 1 Materials and Methods 1.1 Case Selection: Choose a daily incidence of more than 100ml of hemoptysis, a total of 80 cases were randomly divided into bronchoscopy group (referred to as the treatment group) 50 cases and conventional drug combination therapy group (referred to as the control group) 30 cases. The treatment group of 35 males and 15 females, aged 24-68 years old, of which 21 cases of 51 years of age or older, 25 cases of bronchiectasis, bronchitis in 14 cases, 11 cases of pulmonary tuberculosis, massive hemoptysis (more than 500ml / d) in 10 cases, Hemoptysis (200-500ml / d) in 22 cases, a small amount of hemoptysis (100-200ml / d) in 18 cases. The control group of 18 males and 12 females, aged 22-72 years, of which 14 were 51 years of age or older; bronchiectasis in 13 cases, bronchitis in 9 cases, tuberculosis in 8 cases; massive hemoptysis in 6 cases, the amount of hemoptysis in 14 cases, small Hemoptysis in 10 cases. 1,2 Methods: The treatment group preoperative intramuscular injection of atropine 0.5mg stable 10mg, 2% lidocaine for the throat, nasal mucosa spray anesthesia, high flow nasal catheter oxygen and ECG monitoring, the nasal cavity into the mirror, into the sound After the door cleft, bronchial mucosa is filled with 2% lidocaine 2ml anesthesia trachea and bronchial mucosa by bronchoscope suction tube, and the hemorrhage area is ascertained, then the thrombin solution (2000-4000u dissolved in 5ml 0.9% sodium chloride solution). Thirty-two patients with moderate and large amounts of hemoptysis were given norepinephrine 2 mg after proven hemorrhage and thrombin 4000 u was injected with a significant decrease in bleeding. The control group used conventional drugs including pituitrin, anti-fibrinolytic acid,