摘要
目的探讨不同药物止血与支气管动脉栓塞术治疗咯血的临床疗效。方法以我院2014-2016年呼吸内科收治的28例经内科治疗后仍反复少量咯血、并进行支气管动脉栓塞术治疗的患者为研究对象,设为观察组,同期选择内科治疗的50例患者为对照组,对照组A(25例)给予蛇毒血凝酶治疗,对照组B(25例)给予蛇毒血凝酶联合垂体后叶素治疗。比较三组治疗1个月内止血疗效,同时统计两组治疗前后日咯血量、支气管动脉直径及止血药物治疗前后凝血指标比较,并观察两组窒息、胸闷、过敏及下肢深静脉血栓等不良反应发生情况。结果治疗后,观察组总有效率96.4%,明显高于对照组A(76.0%)及对照组B(68.0%),差异具有统计学意义(P<0.05);治疗后三组凝血功能指标PT、APTT、TT及Fbg明显低于治疗前,且观察组优于对照组,对照组B优于对照组A(P<0.05);治疗后三组支气管动脉直径、日咯血量明显低于治疗前,且观察组低于对照组,对照组B低于对照组A(P<0.05);观察组不良反应总发生率7.14%,明显低于对照组A(32.0%)、对照组B(28.0%),差异具有统计学意义(P<0.05)。结论垂体后叶素联合蛇毒血凝酶治疗咯血,其临床疗效优于单独使用止血药治疗,可显著改善咯血症状,如患者保守治疗不佳者,可予以支气管动脉栓塞术治疗,可加强药物治疗疗效,且安全性高、创伤小,可有效改善临床症状。
Objective To explore the clinical efficacy of different hemostatic drugs and bronchial artery embolization in the treatment of hemoptysis.Methods Twenty-eight cases of patients enrolled by respiratory medicine who had a small repeated amount of hemoptysis after medical treatment and were treated with bronchial artery embolization in our hospital between January 2014 and December 2016 were selected for the study and set as the observation group. Another 50 patients under medical treatment in the same period were selected as the control group. Control group A（ 25 cases） was given hemocoagulase treatment while control group B（ 25 cases） was treated with hemocoagulase combined with pituitrin. The hemostatic effects of the three groups were compared within 1 month of treatment. The daily hemoptysis volume and bronchial artery diameter were calculated and coagulation indexes were compared between the two groups before and after treatment with hemostatic drugs. The occurrence of adverse reactions such as asphyxia,chest tightness,allergy and deep venous thrombosis were observed in the two groups. Results After treatment,the total effective rate of the observation group was 96.4%,which was significantly higher than that of control group A（ 76.0%） and control group B（ 68.0%）,so the difference was statistically significant（ P〈0.05）. The levels of coagulation function indexes PT,APTT,TT and Fbg in the three groups were significantly lower after treatment,especially in the observation group（ P〈0.05）. After treatment,the bronchial artery diameter and daily hemoptysis volume in the three groups were significantly smaller,especially in the observation group and control group B（ P〈0.05）. The total incidence of adverse reactions in the observation group was 7.14%,which was significantly lower than that in control group A（ 32.0%） and control group B（ 28.0%）,so that the difference was statistically significant（ P〈0.05）. Conclusion Pituitrin combined with hemocoagulase in the treatment
作者
张航
ZHANG Hang(Department of Emergency,the Third People＇s Hospital of Chengdu,Chengdu 610000,China)
出处
《解放军预防医学杂志》
CAS
2018年第7期851-853,882,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
四川省卫生厅2012科研项目(No.120534)
