Romero Candeira S, Martín Serrano C, Hernández Blasco L
Rev Clin Esp. 1989 Sep;185(4):184-6.
149 patients suffering from hemoptysis of unknown origin who presented a normal chest X-ray were followed up, in order to evaluate their prognosis, during a mean period of 12.6 months after the initial study which included fiberoptic bronchoscopy. During this time, 24 patients (16.1%) presented new episodes of hemoptysis without radiological modifications; a second fiberoptic bronchoscopy carried out in 13 of these patients did not contribute with any new diagnostic data. One patient was diagnosed of pulmonary thromboembolism after persistent hemoptysis and two others of bronchial carcinoma 4 and 30 months after the initial fiberoptic bronchoscopy when the chest X-ray had already suffered significant changes. These data confirm that short term prognosis of cryptogenetic hemoptysis is generally favourable when the fiberoptic bronchoscopy is negative. The fact that a high percentage of these patients (37%, 55/149) had previously suffered pulmonary tuberculosis and/or inflammatory-scar type localized endobronchiolar lesions suggests that sequelae of these diseases, not observed in the X-ray, could play an etiological role in the bleeding.
对149例不明原因咯血且胸部X线检查正常的患者进行了随访,以评估其预后,随访时间为初始研究(包括纤维支气管镜检查)后的平均12.6个月。在此期间,24例患者(16.1%)出现了咯血新发作且无影像学改变;其中13例患者进行的第二次纤维支气管镜检查未提供任何新的诊断数据。1例患者在持续咯血后被诊断为肺血栓栓塞症,另外2例在初始纤维支气管镜检查后4个月和30个月被诊断为支气管癌,此时胸部X线检查已出现明显变化。这些数据证实,当纤维支气管镜检查结果为阴性时,隐源性咯血的短期预后通常良好。这些患者中有很高比例(37%,55/149)既往患有肺结核和/或炎症性瘢痕型局限性细支气管内病变,这表明这些疾病在X线检查中未观察到的后遗症可能在出血中起病因学作用。