Ho ra máu là máu khạc ra từ dưới thanh môn trở xuống, một triệu chứng thường gặp nhưng có rất nhiều nguyên nhân. Ho ra máu nặng được định nghĩa là khi lượng máu ho ra từ > 100 đến > 600 ml trong 24 giờ. Ho ra máu nặng thường là dấu hiệu của một bệnh nặng và có thể gây tử vong do ngạt và tắc nghẽn đường thở. Ho ra máu nặng chiếm khoảng 5% các trường hợp ho ra máu và tỷ lệ tử vong lên tới 80%. Tại Bệnh viện Phổi trung ương đã điều trị nhiều trường hợp ho ra máu nặng bằng phẫu thuật cùng với sự phối hợp của nhiều chuyên khoa khác nhau (Hồi sức tích cực, các phương pháp điều trị nội khoa mới nhất, nút mạch, nội soi can thiệp, …), đã cứu chữa thành công rất nhiều bệnh nhân ho ra máu nặng với nhiều nguyên nhân khác nhau như do di chứng lao phổi, u nấm phổi, giãn phế quản, ung thư phế quản, nhồi máu phổi, các dị tật bẩm sinh phổi, …). Tháng 02/2018 vừa qua, Bệnh viện tiếp nhận một trường hợp ho ra máu nặng có nguy cơ tử vong rất cao. Bệnh nhân được cứu chữa thành công nhờ sự chỉ đạo trực tiếp của Giám Đốc Bệnh viện, sự phối hợp tích cực của nhiều chuyên Khoa, kíp phẫu thuật và việc ứng dụng các kỹ thuật, công nghệ cao trong chẩn đoán, điều trị. Mặc dù tại bệnh viện chuyên khoa đầu ngành về hô hấp, ho ra máu nặng không quá hiếm song trường hợp này lại có rất đặc biệt.
Objectives: To describe the clinical and laboratory features of stage III empyema and to evaluate the effectiveness and safety of using VATS surgery to treat stage III empyema at the Vietnam National Lung hospital. Methods: Propective observational study. From 7/2019 to 01/2020 a total of 58 stage III empyema patients diagnosed who were treated at the Department of Thoracic Surgery – NLH were included in this study. Data were analyzed using SPSS software version 22.0Results: Among 58 patients with stage III empyema, 39 were treated by total VATS surgery, 19 by VATS as supported procedures. The mean age was 45±19.5 (17-85) years old. Male/female ratio :3.83. The main clinical symptoms were chest pain (81.0%), shortness of breath (70.7%), cough (60.3%). Average surgical time: 127.2±41.6(60- 250) minutes, draining time: 7.5±3 days, hospitalization time 10.3±3.4 (5-22) day. 96.6% of patients discharged with well conditions, confirmed by lung well-expanded lungs on Xrays, the success rate was 94.8%, and there was no patient death.Conclusion: Diagnosing stage III empyema was mainly based on clinical symptoms, chest HRCT. VATS surgery is the safe and effective technique, which helps to reduce surgery time, draining, lying down and reducing pain for patients.
Objectives: To describe the clinical and laboratory features of stage III empyema and to evaluate the effectiveness and safety of using VATS surgery to treat stage III empyema at the Vietnam National Lung hospital. Methods: Propective observational study. From 7/2019 to 01/2020 a total of 58 stage III empyema patients diagnosed who were treated at the Department of Thoracic Surgery – NLH were included in this study. Data were analyzed using SPSS software version 22.0. Results: Among 58 patients with stage III empyema, 39 were treated by total VATS surgery, 19 by VATS as supported procedures. The mean age was 45±19.5 (17-85) years old. Male/female ratio :3.83. The main clinical symptoms were chest pain (81.0%), shortness of breath (70.7%), cough (60.3%). Average surgical time: 127.2±41.6(60- 250) minutes, draining time: 7.5±3 days, hospitalization time 10.3±3.4 (5-22) day. 96.6% of patients discharged with well conditions, confirmed by lung well-expanded lungs on Xrays, the success rate was 94.8%, and there was no patient death. Conclusion: Diagnosing stage III empyema was mainly based on clinical symptoms, chest HRCT. VATS surgery is the safe and effective technique, which helps to reduce surgery time, draining, lying down and reducing pain for patients.
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