大咯血的急诊外科治疗

目的 探讨大咯血病人的病因，诊断方法和外科处理措施。方法 对１２例经外科治疗的大咯血病例进行回顾性分析。结果 １２例中有４例肺结核（３３．３％），３例支气管扩张（２５．０％），３例在咯血间歇期急诊作纤支镜判定出血来源，７例通过摄胸片得以定位。１２例病人都作急诊肺叶切除，手术死亡率为８．３３％。结论 大咯血病因以肺结核，支气管扩张多见，胸部摄片和紧急纤维支气管镜为主要诊断方法。急诊肺叶切除能去出血来

Emergence surgical treatment for massive hemoptysis

To study the etiology diagnosis and sungical management of the patients withmassive hemoptysis. Methods Retrospective analysis was made for 12 cases of the patients with massivehemoptysis who were handled through surgical therapy. Results Of the 12 cases, 4 cases werepulmonary tuberculosis, accounting for 33. 3%. 3 cases were bronchiectasis (25. 0% ). With regar tothe site of hemorrhage, 7 cases were determined though chest x-ray, and 3 cases through emergencefibrobronchoscopy during the period of hemoptysis pause. All the 12 cases were underwent emergencelung resection, the operative mortality rate was 8. 3%. Conclusions The most cause of massivehemoptysis was pulmonary tuberculosis and bronchietasis. The main way of diagnosis for massivehemoptysis was chest x-ray and fibrobronchoscopy. Emergeney lung resection can remove the sources ofhemorrhage and rescue patient s life, and with less complication and low mertality. In addition, it mayreduce the risk of bleeding or spreading of infection. Preoperative accurate diagnosis of the site of thepulmonary or brochial hemorrhage was a necessity for the success of surgely. Stable anesthesia withproper tracheal or trach-endobrachial intubation plus adaqate aspiration to keep the lower airmy patent isimportant. Speedy surgical resection of the ill lung is vital. Postoperative mangagement should focus onexpectoration or trachebronchial aspiration of the accunmlated blood or blood clots in the lower airwayand prevention of infection.