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既往接受过治疗的肺结核患者出现大量咯血:病例系列报道

Massive Hemoptysis in Previously Treated Pulmonary Tuberculosis: A Case Series.

作者信息

Iqbal Saba, Nassar Mahmoud, Kondaveeti Ravali, O'Brien Tracey, Siddiqui Raheel S, Lopez Ricardo

机构信息

Internal Medicine, Icahn School of Medicine at Mount Sinai/New York City Health and Hospitals Queens Hospital Center, New York, USA.

Internal Medicine, Icahn school of Medicine at Mount Sinai/New York City Health and Hospitals Queens Hospital Center, New York, USA.

出版信息

Cureus. 2022 Aug 11;14(8):e27882. doi: 10.7759/cureus.27882. eCollection 2022 Aug.

Abstract

Hemoptysis in tuberculosis (TB) is associated with parenchymal distortion and vascular complications linked to prior pulmonary TB. Massive hemoptysis is defined as the expectoration of large volumes of blood. Massive hemoptysis can lead to high morbidity and mortality rates due to hemodynamic instability and airway compromise. In this case series, we present two cases with massive hemoptysis caused by the rupture of the bronchial artery, which achieved hemostasis after fluoroscopy-guided arterial embolization. This series highlights the multiple etiologies of hemoptysis in patients with post-pulmonary TB destruction and the need for various diagnostic and therapeutic modalities. Hemoptysis in patients with prior pulmonary TB can be massive and life-threatening. Timely diagnosis, accurate modality to isolate the source, and appropriate intervention could potentially prevent further lethal complications.

摘要

肺结核(TB)咯血与实质性结构扭曲以及既往肺结核相关的血管并发症有关。大咯血定义为咳出大量血液。由于血流动力学不稳定和气道受压,大咯血可导致高发病率和死亡率。在本病例系列中,我们呈现了两例因支气管动脉破裂导致大咯血的病例,这两例在透视引导下进行动脉栓塞后实现了止血。本系列强调了肺结核破坏后患者咯血的多种病因以及对各种诊断和治疗方式的需求。既往有肺结核的患者咯血可能量很大且危及生命。及时诊断、准确找出出血源的方式以及适当的干预可能会预防进一步的致命并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3ea/9463861/84cdb52cd75a/cureus-0014-00000027882-i01.jpg

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