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复发性咯血的管理:单中心经验。

Management of recurrent hemoptysis: a single-center experience.

机构信息

Department of Pulmonology, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, University of Health Sciences, İstanbul, Turkey.

Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, University of Health Sciences, İstanbul, Turkey.

出版信息

Turk J Med Sci. 2022 Dec;52(6):1872-1880. doi: 10.55730/1300-0144.5534. Epub 2022 Dec 21.

Abstract

BACKGROUND

A successful planning methodology for patients with hemoptysis promises overall improvement in patient care. Conducted in a reference center for chest diseases, the present study aims to analyze characteristics and predictors of interventional methods in patients with recurrent hemoptysis.

METHODS

The present study is a single-center, retrospective observational study. Between 2015 and 2018, 5973 patients with follow-up data until 2021 requiring more than one hospitalization due to recurrent hemoptysis were investigated. Patient characteristics, the amount of hemoptysis, baseline admission parameters, interventional procedures of bronchial artery embolization (BAE), fiberoptic bronchoscopy, rigid bronchoscopy, and surgical resections applied were analyzed according to number of hospitalizations and outcome.

RESULTS

: Hospital admission numbers were higher in patients with sequela of tuberculosis, bronchiectasis and lung cancer. While lung cancer was the most frequent underlying reason in recurrent admissions, it was determined that as the amount of bleeding increased, the number of admissions also increased to the hospital, and BAE and rigid bronchoscopy were performed more frequently in the groups with less frequent admissions. There was no statistically significance between the amount of bleeding, and the interventional procedure alone or in combination with another procedure (p > 0.05).

DISCUSSION

In conclusion, patients with certain diseases may experience frequent hospital admissions due to hemoptysis. Recurrent admissions may get better results with BAE and rigid bronchoscopy. We think that these procedures should be preferred in the foreground of suitable patient selection in line with available facilities and experience.

摘要

背景

对于咯血患者,成功的规划方法有望全面改善患者的护理。本研究在胸科疾病参考中心进行,旨在分析复发性咯血患者介入方法的特点和预测因素。

方法

本研究为单中心回顾性观察研究。2015 年至 2018 年,调查了 5973 例因复发性咯血需要多次住院的患者,这些患者随访数据截至 2021 年。根据住院次数和结局,分析患者特征、咯血量、入院时的基线参数、支气管动脉栓塞(BAE)、纤维支气管镜、硬支气管镜和外科切除等介入治疗方法。

结果

肺结核、支气管扩张和肺癌患者的住院次数更高。虽然肺癌是复发性入院最常见的基础病因,但随着出血量的增加,入院次数也增加,较少住院的患者更频繁地进行 BAE 和硬支气管镜检查。出血量与介入治疗单独或联合其他治疗方法之间无统计学差异(p>0.05)。

讨论

总之,某些疾病的患者可能因咯血而频繁住院。复发性入院通过 BAE 和硬支气管镜检查可能获得更好的效果。我们认为,在符合现有设施和经验的情况下,应根据合适的患者选择将这些程序优先考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a0/10390104/2e6598f9852e/turkjmedsci-52-6-1872f1.jpg

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