正规抗结核治疗后肺结核患者再咯血原因分析

目的分析肺结核病人经正规抗结核治疗后的咯血原因,方法对94例经WHO推荐正规抗结核治疗6～9个月后又再咯血的肺结核病人,经病史、胸片、CT、血象、痰菌检查、纤维支气管镜钳夹及外科术后病理确诊等确定咯血的病因。结果94例病例中,肺结核复发45例,约占47.9%;肺曲菌球27例,约占28.7%;支气管扩张并感染18例,约占19.1%;其它4例,约占4.3%。结论经正规抗结核治疗后肺结核患者再咯血的原因有多种,肺结核复发只是其中原因之一,积极寻找咯血复发的真正原因,才能使患者得到有效的治疗。

Causes of relapsing hemoptysis in patients treated formally as pulmonary tuberculosis

Objective To study the possible causes of relapsing hemoptysis in patients who had been treated formally with anti-tuberculosis drugs. Methods The following procedures including detailed history inquiry,chest X-ray,CT examination,blood cell couting,the bacteriologocal examination of the sputum and the pathological examination of the biopsy specimen accumulated by bronchofiberscope or surgical,were performed to determine the causes for the disease. Results 47.9% of all were relapsing pulmonary tuberculosis,while aspergillom and bronchiectasis complicated by infection showed 28.7% and 19.1% respectively. Conclusion The relapsing pulmonary tuberculosis is only one cause of relapsing hemoptysis,effective therapy should be based on the true diagnosis.