Hemorrhage is one of the most pressing problems in
lung diseases. The paper analyzes the results of medical and surgical treatments for pulmonary
hemorrhages. A total of 724 patients with
hemoptysis and bleedings of various etiology were treated at the Thoracic Unit in 1985-2003. Pulmonary
hemorrhages occurred in 442 (61%) patients with
pulmonary tuberculosis and in 282 (39%) patients with nonspecific
lung diseases. X-ray study revealed right-sided lung lesions in 268 (37%) patients; left-sided lung lesions in 203 (28%), bilateral lesions in 170 (23.5%). The visible X-ray changes were not found in 83 (11.5%) patients. Destructive pulmonary parenchymal changes were detected in 366 (50.5%) patients. Bronchological study was conducted in 703 patients with pulmonary
hemorrhage: 377 (53.7%) and 214 (30.4%) patients were found to have its direct and indirect signs, respectively. Neither changes nor hemorrhagic traces were detected in 112 (15.9%) patients since they underwent bronchoscopy in a later period when
bleeding had already stopped. Foam rubber sponge tamponade of the main and lobar bronchi was made in 75 (10.4%) patients with profuse
bleeding; a positive effect was achieved in 61 (81.3%) patients. The treatment policy for pulmonary
hemorrhage is determined by its severity and etiology and the health status of the patient. A major role was assigned to medical
hemostatic therapy in the treatment of pulmonary
hemorrhages. If it was ineffective, surgical treatment was used. The use of
hypotension controlled by
ganglionic blockers (more commonly
pentamine): bleedings were suppressed in 359 (74%) of 485 patients with second- and third-degree
hemorrhages yielded good results. They were medically stopped in 558 (77%) patients; death occurred in 14 (2.4%) cases. A hundred and fifty two (20.9%) were operated on; of them 8 patients underwent
segmentectomy; 85 had lobectomy. Pulmonectomy, cavernostomy, and
thoracoplasty were performed in 48, 4, and 7 patients, respectively. Twenty-six patients were operated on at the peak of
hemorrhage. Bleedings were suppressed in 140 (92%) patients (they recovered; 12 (7.9%) patients died. In the postoperative period different complications were noted in 30 (19.7%) patients. The final results of medical and surgical treatment were as follows: bleedings were stopped in 698 (96.4%) patients (they recovered) and 26 (3.6%) died.