跳至主要内容

Etiology and an Integrated Management of Severe Hemoptysis Due to Pulmonary Tuberculosis

Read  full  paper  at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53752#.VNHLrSzQrzE

ABSTRACT
Background: It is very important to enhance the therapeutic effect and prognosis of severe tuberculous hemoptysis after the determining of its etiological cause and the source of bleeding. The etiology and integrated curative effect of severe hemoptysis due to pulmonary tuberculosis among 112 inpatients were analyzed. Materials and Methods: The cause was retrospectively analysed. The integrated management effect after the follow-up of mean three years in 112 cases with severe hemoptysis being resulted from pulmonary tuberculosis from June 2008 to July 2012 was described. Active pulmonary tuberculosis ranked the first cause of lower respiratory tract bleeding (32/112, 28.5%), followed by old pulmonary tuberculosis (28/112, 25.0%), tuberculous bronchiectasis (25/112, 22.3%), purified tuberculous cavity (12/112, 10.7%), fungal infection in old pulmonary tuberculosis cavity (9/112, 7.1%), or broncholithiasis (6/112, 5.4%). Almost all suffers with severe hemoptysis were treated by an integrated management, including psychology, anticoagulants, vasoconstrictor agents. Etiological treatment including anti-tuberculosis and anti-infection was simultaneously or subsequently involved. Sixty-four inpatients with severe hemoptysis being failed to be cured by medical treatment were then received selective bronchial artery embolization. Four patients were received surgical wedge resection, lobectomy or pneumonectomy. The total cure rate added up to 98.2% after mean three years’ follow-up. The mortality was 1.8%. Conclusions: Active pulmonary tuberculosis was still responsible for the severe hemoptysis in the southeast region of China. Severe hemoptysis of pulmonary tuberculosis was also resulted from stable tuberculosis, tuberculous bronchiectasis, tuberculosis cavity, fungal infection, or broncholithiasis. Better clinical therapeutic effect could be attained by early etiological diagnosis and comprehensive treatment strategy.
 
Cite this paper
Yang, S. , Mai, Z. , Zheng, X. and Qiu, Y. (2015) Etiology and an Integrated Management of Severe Hemoptysis Due to Pulmonary Tuberculosis. Journal of Tuberculosis Research, 3, 11-18. doi: 10.4236/jtr.2015.31002.
 
References
[1]Sidhu, M., Wieseler, K., Burdick, T.R. and Shaw, D.W.W. (2008) Bronchial Artery Embolization for Hemoptysis. Seminars in Interventional Radiology, 25, 310-318.
http://dx.doi.org/10.1055/s-0028-1085931
 
[2]Najarian, K.E. and Morris, C.S. (1998) Arterial Embolization in the Chest. Journal of Thoracic Imaging, 13, 93-104. http://dx.doi.org/10.1097/00005382-199804000-00004
 
[3]Conlan, A.A., Hurwitz, S.S. and Krige, L. (1983) Massive Hemoptysis. Review of 123 Cases. The Journal of Thoracic and Cardiovascular Surgery, 85, 120-124.
 
[4]Winter, S.M. and Ingbar, D.H. (1988) Massive Hemoptysis: Pathogenesis and Management. Journal of Intensive Care Medicine, 3, 171-188. http://dx.doi.org/10.1177/088506668800300306
 
[5]Halezeroglu, S. and Okur, E. (2014) Thoracic Surgery for Haemoptysis in the Contexts the Best Management Approach? Journal of Thoracic Disease, 6, 182-185.
 
[6]Jean-Baptiste, E. (2000) Clinical Assessment and Management of Massive Haemoptysis. Critical Care Medicine, 28, 1642-1647. http://dx.doi.org/10.1097/00003246-200005000-00066
 
[7]Syabbalo, N. (1991) Hemoptysis: The Third-World Perspective. Chest, 99, 1316-1317.
http://dx.doi.org/10.1378/chest.99.5.1316b
 
[8]Lin, H.H., Dowdy, D., Dye, C., Murray, M. and Cohen, T. (2012) The Impact of New Tuberculosis Diagnostics on Transmission: Why Context Matters. Bulletin of the World Health Organization, 90, 739A-747A. http://dx.doi.org/10.2471/BLT.11.101436
 
[9]Lordan, J.L., Gascoigne, A. and Corris, P.A. (2003) The Pulmonary Physician in Critical Care Illustrative Case 7: Assessment and Management of Massive Haemoptysis. Thorax, 58, 814-819.
http://dx.doi.org/10.1136/thorax.58.9.814
 
[10]Hahn, S., Kim, Y.J., Kwon, W., Cha, S.W. and Li, W.Y. (2010) Comparison of the Effectiveness of Embolic Agents for Bronchial Artery Embolization: Gelfoam versus Polyvinyl Alcohol. Korean Journal of Radiology, 11, 542-546. http://dx.doi.org/10.3348/kjr.2010.11.5.542
 
[11]Zhou, Z.H. (2009) Hemoptysis-Pathogenesis, Diagnosis and Treatment Progress. Modern Preventive Medicine, 36, 1398-1400.
 
[12]Rémy, J., Arnaud, A., Fardou, H., Giraud, R. and Voisin, C. (1977) Treatment of Hemoptysis by Embolization of Bronchial Arteries. Radiology, 122, 33-37. http://dx.doi.org/10.1148/122.1.33
 
[13]Yoon, W., Kim, J., Kim, Y., Chung, T. and Kang, H. (2002) Bronchial and Nonbronchial Systemic Artery Embolization for Life-Threatening Hemoptysis: A Comprehensive Review. Radiographics, 22, 1395-1409. http://dx.doi.org/10.1148/rg.226015180
 
[14]Hirchberg, B., Biran, I., Glazer, M. and Kramer, M.R. (1997) Hemoptysis: Etiology, Evaluation, and Outcome in a Tertiary Referral Hospital. Chest, 112, 440-444.
http://dx.doi.org/10.1378/chest.112.2.440
 
[15]McGuinnes, G., Beacher, J.R., Harkin, T.J., Garay, S.M., Rom, W.N. and Naidich, D.P. (1994) Hemoptysis: Prospective High-Resolution CT/Bronchoscopic Correlation. Chest, 105, 1155-1162.
http://dx.doi.org/10.1378/chest.105.4.1155
 
[16]WHO (2002) WHO Report 2002. Global Tuberculosis Control. Surveillance, Planning, Financing. World Health Organization, Geneva.
 
[17]Li, Y.Y. (1997) Etiology Analysis on Hemoptysis in 520 Elderly Patients. Nanjing Railway Medical College Journal, 16, 189-190.
 
[18]Parrish, S., Krimsky, W., Browning, R. and Alabrash, M. (2012) Novel Approaches to the Patient with Massive Hemoptysis. Journal of Community Hospital Internal Medicine Perspectives, 2, 14784-14787.
http://dx.doi.org/10.3402/jchimp.v2i1.14784
 
[19]Hwang, H.G., Lee, H.S., Choi, J.S., Seo, K.H., Kim, Y.H. and Na, J.O. (2013) Risk Factors Influencing Rebleeding after Bronchial Artery Embolization on the Management of Hemoptysis Associated with Pulmonary Tuberculosis. Tuberculosis and Respiratory Diseases, 74, 111-119.
http://dx.doi.org/10.4046/trd.2013.74.3.111
 
[20]Corr, P.D. (2005) Bronchial Artery Embolization for Life-Threatening Hemoptysis Using Tris-Acryl Microspheres: Short-Term Result. CardioVascular and Interventional Radiology, 28, 439-441.
http://dx.doi.org/10.1007/s00270-004-0227-x
 
[21]Gourin, A. and Garzon, A.A. (1974) Operative Treatment of Massive Hemoptysis. The Annals of Thoracic Surgery, 18, 52-60. http://dx.doi.org/10.1016/S0003-4975(10)65717-7
 
[22]Erdogan, A., Yegin, A., Gürses, G., et al. (2005) Surgical Management of Tuberculosis-Related Hemoptysis. The Annals of Thoracic Surgery, 79, 299-302. http://dx.doi.org/10.1016/j.athoracsur.2004.05.016
 
[23]William, A.B. and James, B.D.M. (1989) Recurrent Major Haemoptysis: Progression to Pneumonectomy. Thorax, 35, 905-906.                                                                                                            eww150204lx
标签：

评论

发表评论

此博客中的热门博文

A Comparison of Methods Used to Determine the Oleic/Linoleic Acid Ratio in Cultivated Peanut (Arachis hypogaea L.)

Cultivated peanut ( Arachis hypogaea L.) is an important oil and food crop. It is also a cheap source of protein, a good source of essential vitamins and minerals, and a component of many food products. The fatty acid composition of peanuts has become increasingly important with the realization that oleic acid content significantly affects the development of rancidity. And oil content of peanuts significantly affects flavor and shelf-life. Early generation screening of breeding lines for high oleic acid content greatly increases the efficiency of developing new peanut varieties. The objective of this study was to compare the accuracy of methods used to classify individual peanut seed as high oleic or not high oleic. Three hundred and seventy-four (374) seeds, spanning twenty-three (23) genotypes varying in oil composition (i.e. high oleic (H) or normal/not high oleic (NH) inclusive of all four peanut market-types (runner, Spanish, Valencia and Virginia), were individually tested ...
发表评论
阅读全文

Location Optimization of a Coal Power Plant to Balance Costs against Plant’s Emission Exposure

Fuel and its delivery cost comprise the biggest expense in coal power plant operations. Delivery of electricity from generation to consumers requires investment in power lines and transmission grids. Placing a coal power plant or multiple power plants near dense population centers can lower transmission costs. If a coalmine is nearby, transportation costs can also be reduced. However, emissions from coal plants play a key role in worsening health crises in many countries. And coal upon combustion produces CO 2 , SO 2 , NO x , CO, Metallic and Particle Matter (PM10 & PM2.5). The presence of these chemical compounds in the atmosphere in close vicinity to humans, livestock, and agriculture carries detrimental health consequences. The goal of the research was to develop a methodology to minimize the public’s exposure to harmful emissions from coal power plants while maintaining minimal operational costs related to electric distribution losses and coal logistics. The objective was...
发表评论
阅读全文

Evaluation of the Safety and Efficacy of Continuous Use of a Home-Use High-Frequency Facial Treatment Appliance

At present, many home-use beauty devices are available in the market. In particular, many products developed for facial treatment use light, e.g., a flash lamp or a light-emitting diode (LED). In this study, the safety of 4 weeks’ continuous use of NEWA TM , a high-frequency facial treatment appliance, every alternate day at home was verified, and its efficacy was evaluated in Japanese individuals with healthy skin aged 30 years or older who complained of sagging of the facial skin.  Transepidermal water loss (TEWL), melanin levels, erythema levels, sebum secretion levels, skin color changes and wrinkle improvement in the facial skin were measured before the appliance began to be used (study baseline), at 2 and 4 weeks after it had begun to be used, and at 2 weeks after completion of the 4-week treatment period (6 weeks from the study baseline). In addition, data obtained by subjective evaluation by the subjects themselves on a visual analog scale (VAS) were also analyzed. Fur...
发表评论
阅读全文