肺结核患者气管动脉栓塞术后再发咯血的临床特征及早期护理预防干预

王小平，付康

（西安市胸科医院，陕西 西安，710061）

浏览次数：87次 下载次数：326次

摘要：

目的 分析肺结核患者气管动脉栓塞术后再发咯血的临床特征及早期护理预防干预的效果。方法 回顾性分析46例行 支气管动脉栓塞术后再发咯血的肺结核患者的临床资料，对再发咯血的时间段及其相关危险因素进行分析。结果 46 例 患者中，共有56 人次再发咯血，咯血发生时间主要在术后1 个月，术后4～10 d 为再发咯血的高峰期（75.00%）；中量咯血 为主要的咯血类型（62.50%）；浸润性肺结核为主要肺结核类型；明胶海绵条为主要栓塞材料；术后活动过早或活动不当 为再发咯血的主要危险因素（42.85%），不同危险因素导致再发咯血时间以术后4～10 d 为主。结论 支气管动脉栓塞术后 的早期再发咯血的临床特征显著，各种危险因素导致再发咯血具有明显的时间段，早期护理干预可有效降低再发咯血的 风险。

关键词：肺结核；气管动脉栓塞术；再发咯血；临床特征；护理干预

中图分类号：R56文献标志码：A文章编号：2096-1413(2017)36-0062-03

Clinical characteristics of recurrent hemoptysis in patients with tuberculosis after tracheal arterial embolization

and the effect of early nursing prevention intervention
WANG Xiao-ping, FU Kang
(Xi``an Chest Hospital, Xi``an 710061, China)

ABSTRACT: Objective To analyze the clinical characteristics of recurrent hemoptysis in patients with tuberculosis after tracheal arterial embolization and the effect of early nursing prevention intervention. Methods The clinical data of 46 tuberculosis patients with recurrent hemoptysis after tracheal arterial embolization were retrospectively analyzed, and the recurrence of hemoptysis period and its related risk factors were analyzed. Results Among 46 tuberculosis patients, a total of 56 times repeated hemoptysis. The occurrence time of hemoptysis was mainly in 1 month after operation, 4~10 d after operation was the peak period of recurrent hemoptysis (75.00%); a medium amount of hemoptysis was the major type of hemoptysis (62.50%); invasive pulmonary tuberculosis was the main type of tuberculosis; gelatin sponge was the main embolism materials; early postoperative activity or improper activities was a major risk factor for recurrent hemoptysis (42.85%), the time of recurrent hemoptysis caused by different risk factors was 4~10 d after operation. Conclusion The clinical features of early recurrent hemoptysis after tracheal arterial embolization are significant, all kinds of risk factors lead to recurrent hemoptysis in a clear period of time. Early nursing intervention can effectively reduce the risk of recurrent hemoptysis.
KEYWORDS: tuberculosis; tracheal arterial embolization; recurrent hemoptysis; clinical characteristics; nursing intervention

参考文献：
[1] 李成业,孙丽娟,曹玮,等.支气管动脉栓塞术治疗肺结核大咯血的 临床疗效及对肺功能的影响[J].广西医科大学学报,2017,34(3):434.
[2] 贺光辉,刘文玉,高志,等.老年肺结核并发肺曲霉病大咯血介入栓 塞治疗[J].介入放射学杂志,2016,25(4):350-353.
[3] 齐莉英.心理干预对肺结核咯血介入治疗患者的影响[J].齐鲁护理 杂志,2015,21(5):103-104.
[4] 王莉端,潘琴,陈荣,等.护理干预对肺结核患者心理状态及生活质量的影响[J].广东医学,2014,26(11):1802-1804.
[5] 靳成娟,杜建,杨怀盛,等.中国人群肺结核发病危险因素的荟萃分 析[J].军事医学,2014,38(5):355-359,364.
[6] GLEESON LE,SHEEDY FJ,PALSSON-MCDERMOTT EM,et al.Cutting edge: mycobacterium tuberculosis induces aerobic glycolysis in human alveolar macrophages that is required for control of intracellular bacillary replication[J].J Immunol,2016,196(6):2444-2449.
[7] HE F,XIONG Y,LIU J,et al.Construction of Au-IDE/CFP10-ESAT6 aptamer/DNA-AuNPs MSPQC for rapid detection of Mycobacterium tuberculosis[J].Biosens Bioelectron,2016,(77):799-804.
[8] 周春萍,许日波,李源,等.综合护理干预对肺结核并咯血患者疗效 的影响[J].齐鲁护理杂志,2014,20(11):67-68.
[9] 丁健,王永利,王征宇,等."三明治"式支气管动脉栓塞术治疗咯血 的临床疗效分析[J].介入放射学杂志,2014,23(3):245-249.
[10] MARTINEZ-LOPEZ A,RUIZ-VILLAVERDE R.Latent tuberculosis infection: diagnostic update before introduction of biological drugs [J]. Eur J Dermatol,2016,26(3):307-308.
[11] 肖兵,宋建琼,陈俊霖,等.支气管动脉栓塞术在药物治疗后仍反复 小量咯血患者中的应用[J].西部医学,2015,27(9):1377-1378,1381.
[12] 周玉玲,徐震,王世杰,等.支气管动脉栓塞术治疗咯血失败的原因 分析及处理[J].中国伤残医学,2014,22(4):125-126.
[13] 吴常明,邱跃灵,殷建团,等.支气管动脉栓塞术治疗148 例大咯血 回顾性临床分析[J].国际呼吸杂志,2017,37(2):130-135.
[14] DE VG,VAN RJ,MEIJER W,et al.Low yield of screening asylum seekers from countries with a tuberculosis incidence of <50 per 100 000 population[J].Eur Respir J,2016,47(6):1870-1872.
[15] 何阳,曹军,刘洪强,等.支气管动脉栓塞术治疗大咯血疗效观察 [J].山东医药,2014,58(16):35-37.