ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHÂN HO RA MÁU DO LAO PHỔI CẦN ĐIỀU TRỊ PHẪU THUẬT TẠI BỆNH VIỆN PHỔI TRUNG ƯƠNG

Abstract

Objective: To evaluate the initial treatment outcomes of surgery for hemoptysis in pulmonary tuberculosis (PTB) patients at the National Lung Hospital. Subjects and Methods: The study involved 50 patients diagnosed with hemoptysis due to PTB who underwent surgery at the National Lung Hospital from July 2017 to June 2024. Results: The average age is 46.86 years, with the age group 41-60 being the largest (46%). Male patients predominated (74%). Patients with severe hemoptysis often presented with dyspnea and had higher rates of positive AFB sputum smears (48%) and molecular tests (84%). Chest CT scans identified bronchial artery system lesions as the most frequent finding (50%); 12% of patients had lesions in the non-bronchial systemic arteries; aneurysms or pseudoaneurysms present in 40% of patients. Among the 22 patients who underwent Digital Subtraction Angiography (DSA), 7 had isolated bronchial artery system lesions, all of whom were in the severe hemoptysis group; 14 patients had lesions involving both arterial systems. Hypertrophy and hyperplastic bronchial arteries were the two most common morphological findings. Furthermore, 40.91% of patients showed anastomotic vessels, and 4.55% had tortuous vessels on DSA. Notably, a significant portion of patients (40.91%) had three or more pathological vessels. Conclusion: Hemoptysis is a common medical emergency with numerous causes. In Vietnam, PTB remains the leading cause. For the patient group requiring surgery, clinical symptoms are often severe, and vascular lesions on CT scans and DSA are typically complex. This necessitates a coordinated approach involving both aggressive medical treatment and surgical intervention.