目的:探讨酚妥拉明治疗不同病因肺咯血的疗效.方法:选择不同病因引起的大量和中量肺咯血71例,按不同病因分为5组.Ⅰ组:肺心病合并结核性支气管扩张咯血12例.Ⅱ组:高血压性心脏病合并支气管扩张咯血14例.Ⅲ组:空洞型肺结核毁损肺咯血17例.Ⅳ组:支气管扩张咯血15例.Ⅴ组:肺癌咯血13例.全部病例均按不同病因进行基础病治疗.同时用酚妥拉明5～10 mg加入5% GS20～40 mL静注,然后用10～20 mg酚妥拉明加入5% GS250～500 mL静滴.结果:各组对酚妥拉明的治疗疗效不同,Ⅰ、Ⅱ组的有效率为100%(26/26),III、IV、V组的有效率仅为42.22%(19/45),Ⅰ、Ⅱ组和Ⅲ、Ⅳ、Ⅴ组疗效比较,差异十分显著P＜0.001.各组咯血与疗效形式的关系也不同.Ⅰ、Ⅱ组大咯血15例,中量咯血11例,其显效率高达84.62%(22/26).而Ⅲ、Ⅳ、Ⅴ组大咯血28例,中量咯血17例,其显效率仅为4.4%(2/45),Ⅰ、Ⅱ组与Ⅲ、Ⅳ、Ⅴ组咯血量与疗效的关系显著不同,前者的止血几乎都呈显效,而后者多为有效而已,P＜0.001.结论:酚妥拉明治疗肺咯血,对存在肺动脉,肺静脉高压且有肺淤血者,疗效最好.
Objective:To explore the therapeutic results of Phentolamine in pulmonary hemoptysis for various causes.Methods:Seventy-one cases of hemoptysis of both large and medium expectorated amount were divided into five groups according to different causes.Group Ⅰ:12 cases of hemoptysis associated with pulmonary heart disease complicated by bronchiectasis. Group Ⅱ:14 cases of hemoptysis resulting from gypertensive heart disease complicated by by bronchiectases.Group Ⅲ:17 cases of hemoptysis caused by pulmonary damage due to cavernous type pulmonary buberculosis.Group Ⅳ:15 cases of hemoptysis caused by bronchiectasis; Group Ⅴ:13 cases of hemoptysis attributed to pulmonary carcinoma. All the cases were treated according to their underlying causes and in conjunction with the treatment of hymoptysis using Phentolamine(5~10 mg in 5% GS 20~40 mL),and then using 10-20 mg of Phentolamine in 5% GS250~500 mL(i.v.) Results: Groups Ⅰ and Ⅱ showed a 100% effective rate (26/26)while Group Ⅲ,Ⅳ and Ⅴ showed a effective rate of only 42.22%(19/45) with a marked difference (P<0.001)between Groups Ⅰ,Ⅱand Groups Ⅲ,Ⅳ and Ⅴ. The relationship among these groups between the expectorated blood amount and the therapeutic effects were also different.GroupsⅠ and Ⅱ had 15 cases of large amount of expectorated blood and 11 of medium amount of expectorated blood,with an effective rate as high as 84.62%(22/26).On the other hand,Groups Ⅲ,Ⅳand Ⅴ had 28 cases of large expectorate blood amount and 17 of medium amount,with an effective rate of only 4.4%(2/45).Groups Ⅰ,Ⅱand Groups Ⅲ,Ⅳ and Ⅴ showed a significant difference between the expectorated amount and therapeutic effects. The cases of the former groups almost invariably showed an obvious hemostatic effect whereas those of the latter groups almost invariably showed an obvious hemostatic effect whereas those of the latter groups mostly manifested only certain result. Conclusion:Phentolamine produces the best therapeutic result in cases of hemoptysis with h
Practical Clinical Medicine
hypertension of pulmonary arteries and veins