经纤支镜介入治疗咯血的疗效观察

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90例中、大量咯血患者随机分成3组。组1（纤维蛋白原组）用2％纤维蛋白原5ml，经纤维支气管镜FB（Olympus P40）于出血部位局部灌注，继之用凝血酶1000U加5mL生理盐水溶解后再灌注。组2（凝血酶组）用凝血酶1000U局部灌注（方法同上）。组3（止血药物组）用垂体后叶素5～10U加入5％GS或GNS500ml中，静脉点滴1～2次／d，同时给予常规止血药物止血敏2～3g，止血芳酸0．4～0．6g，加入补液中静脉点滴1次/d。组3治疗无效者可进入组1或组2。结果：统计学检验显示，3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（P〈0．05）；而组1较组2疗效更优（P=0．05）。结论：经纤维支气管镜（FB）局部灌注凝血药物的止血效果优于静脉用药；经FB纤维蛋白原加凝血酶联合使用疗效优于单用凝血酶者。

An Observation of the Effectiveness in the Treatment of Hemoptysis by Interventional Treatment Via Bronchoscopy

Objective: To search and study a more effective and convenient method in the treatment of hemoptysis. Method: 90 moderate and severe hemoptysis cases were divided into 3 groups randomly, Gr. 1 was infused with fibrinogen and thrombin via bronchoscopy; Gr.2 was infused with thrombin only. Gr.3 was injected vasopressin and antifibrinolysins(PAM-BA and AMCHA) intravenously. Gr.3 can enter Gr.1 or Gr.2 when the treatment was inefficient. Result: The treatment effect among the three groups had significant difference statistically(P=0 .0001).The treatment effect of Gr.1 and Gr. 2 was better than that of Gr. 3 (P<0.05).The treatment effect of Gr. 1 was better than that of Gr.2(P=0.05).Conclusion: The combination of fibrinogen and thrombin used via bronchoscopy is an effective method in the treatment of hemoptysis, it is better than single drug used.