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[183例支气管热成形术短期呼吸不良事件分析]

[Analysis of short-term respiratory adverse events in 183 bronchial thermoplasty procedures].

作者信息

Nong Y, Lin J T, Su N, Chen X, Zhao Q, Han C Y, Qiu R F

机构信息

Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2017 Mar 12;40(3):176-181. doi: 10.3760/cma.j.issn.1001-0939.2017.03.007.

DOI:10.3760/cma.j.issn.1001-0939.2017.03.007
PMID:28297811
Abstract

To analyze the short-term (3 weeks) adverse respiratory events after bronchial thermoplasty(BT) in patients with severe asthma. The China-Japan Friendship Hospital recruited 62 patients with severe asthma for BT treatment from March 2014 to July 2016, with a total of 183 BT procedures. The data of adverse respiratory events within 3 weeks after procedure were collected to analyze the factors that might potentially influence the occurrence of adverse events. Forty-three patients (69.4%) experienced adverse respiratory events within 3 weeks after treatment. Totally 153 adverse respiratory events occurred after 87 procedures(47.5%). The main adverse events were cough (15 events, 8.20%), sputum production (37 events, 20.22%), temporary PEF reduction (37 events, 20.22%), chest distress (12 events, 6.56%), blood in sputum (11 events, 6.01%), asthma exacerbation (10 events, 5.46%), and pneumonia(6 events, 3.28%). Most events were relieved or resolved with standard therapy in 1 week. No severe adverse events including tracheal intubation, malignant arrhythmias or death occurred within 3 weeks after procedure. The baseline eosinophil percentage in induced sputum and blood, operation times, and preoperative FEV(1) (% predicted) might influence the occurrence of adverse events after treatment. Patients with preoperative FEV(1) (% predicted) ≥60% had lower risk of adverse events. BT showed a good security profile in treating patients with severe asthma within 3 weeks after procedure.

摘要

分析重度哮喘患者接受支气管热成形术(BT)后短期内(3周)的不良呼吸事件。中日友好医院于2014年3月至2016年7月招募了62例重度哮喘患者接受BT治疗,共进行了183例BT手术。收集术后3周内不良呼吸事件的数据,以分析可能影响不良事件发生的因素。43例患者(69.4%)在治疗后3周内发生了不良呼吸事件。87例手术(47.5%)后共发生153起不良呼吸事件。主要不良事件包括咳嗽(15起,8.20%)、咳痰(37起,20.22%)、临时呼气峰流速降低(37起,20.22%)、胸闷(12起,6.56%)、痰中带血(11起,6.01%)、哮喘加重(10起,5.46%)和肺炎(6起,3.28%)。大多数事件在1周内通过标准治疗得到缓解或解决。术后3周内未发生包括气管插管、恶性心律失常或死亡在内的严重不良事件。诱导痰和血液中的基线嗜酸性粒细胞百分比、手术次数以及术前第1秒用力呼气容积(FEV₁)(预测值%)可能会影响治疗后不良事件的发生。术前FEV₁(预测值%)≥60%的患者发生不良事件的风险较低。BT在术后3周内治疗重度哮喘患者时显示出良好的安全性。

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1
[Analysis of short-term respiratory adverse events in 183 bronchial thermoplasty procedures].[183例支气管热成形术短期呼吸不良事件分析]
Zhonghua Jie He He Hu Xi Za Zhi. 2017 Mar 12;40(3):176-181. doi: 10.3760/cma.j.issn.1001-0939.2017.03.007.
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引用本文的文献

1
Puzzling onsets of pneumonia sequentially after each session of bronchial thermoplasty: a case report.支气管热成形术每疗程后序贯性肺炎发作:病例报告。
BMC Pulm Med. 2020 Aug 11;20(1):211. doi: 10.1186/s12890-020-01243-2.
2
Chinese expert consensus on diagnosis and management of severe asthma.《中国重症哮喘诊断与治疗专家共识》
J Thorac Dis. 2018 Dec;10(12):7020-7044. doi: 10.21037/jtd.2018.11.135.
3
Bronchial thermoplasty-an update.支气管热成形术——最新进展
Ann Thorac Med. 2018 Oct-Dec;13(4):205-211. doi: 10.4103/atm.ATM_365_17.