肺结核大咯血支气管动脉栓塞治疗的远期疗效观察

目的评价支气管动脉栓塞治疗肺结核大咯血的远期疗效。方法42例均为继发性肺结核，双侧肺结核27例，单侧肺结核15例。采用支气管动脉插管造影，证实为出血动脉后，将PVA微粒或丝线段缓慢注入靶血管内，直至血流停止。结果一次栓基后34例达到立即止血的目的，7例咯血明显减少，1例无效，近期有效率97．6％，无严重并发症：术后随访6月～7年，24例达临床治愈，显效7例，有效5例，复发6例，远期有效率85．7％结论支气管动脉栓塞治疗肺结核大咯血是一安全、迅速有效的治疗方法，远期止血效果好，并发症少，结合抗痨治疗有利于巩固疗效。

The Long-term Efficacious Observation of Bronchial Artery Embolization for Massive Hemoptysis of Pulmonary Tuberculosis

Objective To evaluate the long-term curative effect of bronchial artery embolization on massive hemoptysis in patients with pulmonary tuberculosis. Methods Bronchial arterial embolization with PVA grain and silk segment was performed in 42 cases of patients with hemoptysis of secondary pulmonary tuberculosis. Of them, 27 cases were bilateral pulmonary tuberculosis and 15 lateralized. The bloody bronchial arteries were confirmed by bronchial arteriography, and the PVA grains or silk segments were injected slowly into the target vessels until hemorrhage stopped. Results After one time embolization, hemoptysis stopped immediately in 34 cases, 7 cases still had little hemoptysis,and one case of hemorrhage was unable to be controlled. The short-term efficacious rate was 97.6%,and no severe complications occurred. Followed up 6 months to 7 years after treatment,24 cases were clinical cure,7 cases obviously effective,5 cases effective,and 6 cases recurrent.The long-term effective rate is 85.7%. Conclusion Embolization of bronchial artery with PVA grain and silk segment was a safe and effective method for controlling hemoptysis of pulmonary tuberculosis, and its combination with anti-tuberculosis treatment could consolidate the curative effect.