Halezeroğlu Semih, Okur Erdal
Thoracic Surgery Department, Acıbadem University, Faculty of Medicine, Istanbul, Turkey.
J Thorac Dis. 2014 Mar;6(3):182-5. doi: 10.3978/j.issn.2072-1439.2013.12.25.
Haemoptysis is not an unusual finding in patients with old or active pulmonary tuberculosis. Because of bronchial artery or a branch of pulmonary artery erosion due to cavitary infiltration, bronchiectasis, fungus ball, broncholithiasis or destroyed lung, the bleeding can sometimes be a life-threatening situation. Assessment of the patient and finding the exact site of bleeding can be difficult especially in a patient with disseminated lung disease. Chest computerized tomography and bronchoscopy remain the methods of choice for lateralization of the disease. Some patients can be treated successfully with endobronchial interventions. Bronchial artery embolization can be rewarding in some patients but the recurrence rate is higher in tuberculosis than other etiologies of haemoptysis. Surgical resection of the lung, mainly lobectomy, remains a life-saving procedure but it should be performed very selectively to avoid higher postoperative morbidity and mortality. Different management options of haemoptysis in patients with pulmonary tuberculosis are discussed in this manuscript.
咯血在陈旧性或活动性肺结核患者中并非罕见发现。由于空洞浸润、支气管扩张、曲菌球、支气管结石或肺毁损导致支气管动脉或肺动脉分支侵蚀，出血有时可能危及生命。对患者进行评估并确定出血的确切部位可能很困难，尤其是在患有播散性肺部疾病的患者中。胸部计算机断层扫描和支气管镜检查仍然是确定病变部位的首选方法。一些患者可通过支气管内干预成功治疗。支气管动脉栓塞对一些患者可能有效，但肺结核患者的复发率高于其他咯血病因。肺手术切除，主要是肺叶切除术，仍然是一种挽救生命的手术，但应非常有选择性地进行，以避免较高的术后发病率和死亡率。本文讨论了肺结核患者咯血的不同管理选择。
