Xu Weihua, Wang Hongwei, He Haidong, Hu Huiping, Lu Haihua, Li Guozheng
Respiration Department Tongde Hospital of Zhejiang Province Hangzhou China.
Anesthesiology Department Tongde Hospital of Zhejiang Province Hangzhou China.
Respirol Case Rep. 2019 Mar 25;7(5):e00418. doi: 10.1002/rcr2.418. eCollection 2019 Jul.
Massive haemoptysis is life-threatening. Management options include pharmacological treatment, bronchial artery embolization, surgical resection, and bronchoscopic interventions. As an alternative treatment method of controlling haemoptysis, endobronchial stent insertion has been performed in several pulmonary carcinoma patients. We presented an 89-year-old bronchiectasis patient who developed massive haemoptysis from the right middle lobe bronchus. Haemoptysis was not controlled by both pharmacological treatment and bronchial artery embolization. Two customized silicone stents with the one in the right middle lobe bronchus and another in the right intermediate bronchus were used to manage haemoptysis. One month after stents implantation, the stent inside the right intermediate bronchus was removed, another stent was left in the right middle lobe bronchus to continue occluding the bleeding passageway. Haemoptysis did not occur after silicon stents deployment. This may be the first case of receiving straight silicon stent implantation to manage massive haemoptysis from the right middle lobe bronchus.
大量咯血危及生命。治疗选择包括药物治疗、支气管动脉栓塞、手术切除和支气管镜干预。作为控制咯血的一种替代治疗方法,已在数名肺癌患者中进行了支气管内支架置入术。我们报告了一名89岁的支气管扩张患者,其右中叶支气管出现大量咯血。药物治疗和支气管动脉栓塞均未能控制咯血。使用了两个定制的硅酮支架,一个置于右中叶支气管,另一个置于右中间支气管以控制咯血。支架植入一个月后,取出右中间支气管内的支架,另一个支架留在右中叶支气管以继续阻塞出血通道。硅酮支架置入后未再发生咯血。这可能是首例接受直形硅酮支架植入术治疗右中叶支气管大量咯血的病例。