Evaluation of timing and safety about different interventional methods of fiberoptic bronchoscopy for massive pulmonary haemoptysis

Abstract

Objective Discussion of timing and safety about different interventional methods of fiberoptic bronchoscopy for massive pulmonary haemoptysis.Methods Twenty one patients with massive pulmonary haemoptysis were recruited from Jan 2010 to Nov 2012 in our Department (19 males,2females).All patients were randomized to an interventional method of fiberoptic bronchoscopy with micro-catheter imbedding hemostasia (method A),oxidized regenerated cellulose (ORC) hemostatic gauze imbedding hemostasia (method B),and argon plasma coagulation (APC) hemostasia (method C).Evaluation of the timing and safety of these three methods was performed based on the instant control rate of massive hemoptysis,degree of difficulty of the surgical procedure,consumed time,and the incidence of complications.Results In all patients,12 cases were performed with method A,6 cases were performed with method B,and 3 cases were performed with method C.The instant control rates of massive hemoptysis were 75％,83.3％,and 100％,respectively.All the procedures were performed successfully,and the consumed time was from 3 to 10 min.Nasal bleeding,and a hoarse voice were appeared in groups with method A and B,but not method C.Varying degrees of fever,chest tightness and shortness of breath were appeared in all groups,but obvious chest pain,atelectasis,obstructive pneumonia,lung abscess,local mucosal of oppression necrosis and burns were disappeared in all groups.1 case was appeared catheter slippage in group with method A,1 case was appeared expectoration of ORC hemostatic gauze in group with method B,and 1 case was appeared the front of the bronchoscope damage due to fiberoptic bronchoscopy burning in group with method C.Conclusions For the interventional methods of fiberoptic bronchoscopy for massive pulmonary haemoptysis,the interventional methods with more expert,simpler,shorter time-consuming,more reliable effective were willing to accepted by the patients.However,each method has its own limitation,it need to be mastered strictly. Key words: Massive pulmonary haemoptysis; Fiberoptic bronchoscopy; Micro-catheter imbedding; Oxidized regenerated cellulose hemostatic gauze; Argon plasma coagulation; Timing; Safety