支气管扩张并咯血.ppt

Chart Rounds Reporter：Dr.Dongping Xu VS：Dr.Jinhua Sun Dr.Liang Chen Date：December 10, 2014 Personal history Name：Chen xx Gender：Male Age：62 Occupation：None Date of admission：2014.11.03-2014.11.17 Chart number：1034671 Chief complaint Cough, sputum 40 years, hemoptysis one hour Q1：What is hemoptysis？ A1：The following supraglottic airway or lung tissue bleeding, tissue out through the mouth Q2：Identification of hemoptysis？ A2： oral hemorrhage nasal hemorrhage hematemesis Q3：Causes of hemoptysis？ A3 Airways diseases Pulmonary parenchymal diseases Pulmonary vascular disorders Cryptogenic Johnston H, Reisz G. Changing spectrum of hemoptysis. Underlying causes in 148 patients undergoing diagnostic flexible fiberoptic bronchoscopy. Arch Intern Med 1989; 149:1666. Airways diseases Bronchitis and bronchiectasis Neoplasm Foreign bodies Airway trauma Fistulas Dieulafoy lesion Pulmonary parenchymal diseases Infection Rheumatic and immune disorders Genetic disorders of connective tissue Coagulopathy Iatrogenic Cocaine-induced pulmonary hemorrhage Pulmonary parenchymal diseases Catamenial hemoptysis Bevacizumab treatment Nitrogen dioxide exposure in indoor ice arenas US survey shows: The most common cause-- bronchitis (26%) Lung cancer (23%) Pneumonia (10%) Tuberculosis (8%) Postgrad Med 2002;112:101-13 A study in South Africa found that the cause of hemoptysis were: Tuberculosis Bronchiectasis Necrotizing pneumonia Abscess Bronchial arteriovenous fistula Invasive fungal infections Bleeding disorders Postgrad Med 2002;112:101-13 Dia