Fekri Mitra Samareh, Hashemi-Bajgani Seyed Mehdy, Shafahi Ahmad, Zarshenas Rozita
Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Department of Pulmonary, Afzalipour Hospital Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Iran J Med Sci. 2017 Mar;42(2):129-135.
Hemoptysis occurs due to either pulmonary diseases or bronchoscopy interventions. The aim of the present study was to compare the efficacy of the endobronchial instillation of adrenaline with that of tranexamic acid.
Fifty patients were randomly selected as 2 double-blinded sample groups (n=25). In these patients, bleeding could not be controlled with cold saline lavage during bronchoscopy and they, therefore, required prescription of another medicine. Adrenaline (1 mg) in one group and tranexamic acid (500 mg) in the other group were diluted in 20 mL of normal saline and instilled through the bronchoscope. This technique was repeated 3 times at 90-second intervals, if necessary. In the case of persistent bleeding, 90 seconds after the last dose, a second medicine was given for bleeding control. Observation of clot through the bronchoscope meant that the bleeding had stopped. The efficacy of tranexamic acid and adrenaline was evaluated and then compared using the Mann-Whitney test.
The time of bleeding control had no significant difference between tranexamic acid and adrenaline (P=0.908). Another analysis was done to evaluate bleeding control with a second medicine; the results showed that 1 (4%) patient in the tranexamic acid and 8 (32%) in the adrenaline group needed the second medicine and there was no significant difference between the 2 groups (P=0.609).
Our results suggested that tranexamic acid by endobronchial instillation was as efficient as adrenaline in controlling hemoptysis and required less frequent use of a second medicine. IRCT2014120220188.
咯血可由肺部疾病或支气管镜检查干预引起。本研究的目的是比较支气管内注入肾上腺素与氨甲环酸的疗效。
随机选取50例患者作为2个双盲样本组（n = 25）。这些患者在支气管镜检查期间用冷盐水灌洗无法控制出血，因此需要开具另一种药物。一组用1 mg肾上腺素，另一组用500 mg氨甲环酸，分别用20 mL生理盐水稀释后通过支气管镜注入。如有必要，该技术以90秒的间隔重复3次。在持续出血的情况下，最后一剂给药90秒后，给予第二种药物以控制出血。通过支气管镜观察到血凝块意味着出血停止。评估氨甲环酸和肾上腺素的疗效，然后使用曼-惠特尼检验进行比较。
氨甲环酸和肾上腺素在控制出血时间上无显著差异（P = 0.908）。进行另一项分析以评估第二种药物控制出血的情况；结果显示，氨甲环酸组有1例（4%）患者需要第二种药物，肾上腺素组有8例（32%）患者需要第二种药物，两组之间无显著差异（P = 0.609）。
我们的结果表明，支气管内注入氨甲环酸在控制咯血方面与肾上腺素一样有效，且需要使用第二种药物的频率较低。IRCT2014120220188。
