Department of Anesthesia, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China.
Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China.
BMC Pulm Med. 2024 Aug 21;24(1):402. doi: 10.1186/s12890-024-03205-4.
Surgery is the main treatment option for destroyed-lung (DL) patients with life-threatening massive hemoptysis. However, short-term and long-term surgical safety and efficacy are unclear, prompting this study.
Data from 124 DL patients undergoing surgery between November 2001 and January 2022 at Beijing Chest Hospital were retrospectively analyzed. Data of the DL group (82 cases) and DL + massive hemoptysis group (42 cases) were compared with regard to clinical characteristics, long-term postoperative residual lung reinfection.
As compared with DL group rates, The DL + massive hemoptysis group had greater incidence rates of postoperative complications, invasive postoperative respiratory support, long-term postoperative residual lung reinfection, and postoperative tuberculosis recurrence. Revealed risk factors for postoperative complications (Extent of lung lesion resection), postoperative invasive respiratory therapy (preoperative Hb < 9 g/L, severe intraoperative hemoptysis), and postoperative long-term residual lung reinfection (DL with massive hemoptysis).
DL patients with massive hemoptysis had greater rate of invasive respiratory support therapy and postoperative complications. Extensive lesion removal, preoperative anaemia, severe intraoperative bleeding associated with recent postoperative complications for the patient.
对于有生命威胁性大咯血的毁损肺（DL）患者，手术是主要的治疗选择。然而，短期和长期手术的安全性和疗效尚不清楚，促使进行了这项研究。
回顾性分析了 2001 年 11 月至 2022 年 1 月在北京胸科医院接受手术的 124 例 DL 患者的数据。比较了 DL 组（82 例）和 DL+大咯血组（42 例）的临床特征、长期术后残余肺再感染情况。
与 DL 组相比，DL+大咯血组术后并发症、有创术后呼吸支持、长期术后残余肺再感染和术后结核复发的发生率更高。揭示了术后并发症（肺病变切除范围）、术后有创呼吸治疗（术前 Hb<9g/L、术中严重咯血）和术后长期残余肺再感染（DL 合并大咯血）的危险因素。
伴有大咯血的 DL 患者有更高的有创呼吸支持治疗和术后并发症发生率。广泛的病变切除、术前贫血、术中严重出血与术后近期并发症相关。
