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中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (01) : 1 -8. doi: 10.3877/cma.j.issn.1674-6902.2019.01.001

所属专题: 指南与规范 文献 指南共识

指南与共识

大咯血诊疗规范
中国医师协会整合医学分会呼吸专业委员会1   
  1. 1. 710038 西安,空军军医大学(第四军医大学)唐都医院呼吸与危重症医学科
  • 收稿日期:2019-01-10 出版日期:2019-02-20
  • 基金资助:
    国家公益性行业科研专项(201402024)

Stangdard for diagnosis and treatment of massive hemoptysis

Association integrated medicine branch respiratory profesional committee1   

  • Received:2019-01-10 Published:2019-02-20
引用本文:

中国医师协会整合医学分会呼吸专业委员会. 大咯血诊疗规范[J]. 中华肺部疾病杂志(电子版), 2019, 12(01): 1-8.

Association integrated medicine branch respiratory profesional committee. Stangdard for diagnosis and treatment of massive hemoptysis[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(01): 1-8.

表1 大咯血的常见病因
图1 硬质支气管镜下肿物切除;注:因咯血就诊,发现气管上段球形新生物,向管腔内生长,表面血运丰富,触之出血。硬质下氩气刀烧灼止血
图2 球囊压迫止血;注:患者突发大咯血、窒息,给予气管插管并支气管镜吸引,并给予球囊压迫后止血
图3 支气管镜下氩气刀止血
图4 支气管镜下冷冻取血栓;注:大咯血患者,呼吸衰竭,给予气管插管呼吸机辅助呼吸,急诊支气管镜检查发现左主支气管被血栓堵塞,冷冻探头进入血栓部位,拉出血栓,取除物呈支气管树样改变。取出2条血栓树后见左主支气管及各级支气管管腔均通畅
图5 支气管动脉DSA造影支气管动脉栓塞术后;注:大咯血患者,行支气管动脉DSA显示造影剂剂外溢,给予支气管动脉栓塞术后,未见显影,咯血停止
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