经支气管镜气道内球囊压迫术治疗呼吸道大咯血的临床研究

目的观察经支气管镜气道内球囊压迫术治疗呼吸道大咯血的临床疗效及不良反应.方法选取我院2009年8月-2012年4月诊治的60例呼吸道大咯血的患者,随机分为球囊压迫组及支气管动脉栓塞组各30例,观察两组临床疗效、止血时间、住院费用、住院天数、复发率及并发症.结果球囊组的临床总有效率达90%,优于栓塞组(83.3%),但组间差异无统计学意义(P>0.05),止血时间为2.6±0.93h,显著低于栓塞组(5.9±1.37)h,差异有统计学意义(P<0.05);两组的住院天数比较无统计学差异(P>0.05);随访5-8个月,球囊组患者咯血的复发率为20%,稍高于栓塞组(13.3%),但差异无统计学意义(P>0.05),并发肺不张、咳嗽等发生率为26.6%,高于栓塞组(13.3%),但差异无统计学意义(P>0.05).结论纤维支气管镜气道内球囊压迫治疗呼吸道大咯血,操作简便、起效快且效果显著,值得临床推广应用.

Study of balloon block in treatment of massive hemoptysis

Objective To evaluate the curative efficacy of balloon block in treatment of massive hemoptysis.Methods Sixty patients with massive hemoptysis were divided into two groups randomly.Thirty patients were treated by bronchial baloon block（balloon group） and the other 30 by bronchial arterial embolization（embolization group）.The curative rates,relapsing rates,complications and expenses and days of hospitalization were observed.Results The curative rate in baloon group was higher than that in embolization group,but the difference was not statistically significant（90% Vs 82.3%,P 0.05）,the time for hemostasis in balloon group was significantly shorter than that in embolization group（2.6±0.93h Vs 5.9±1.37h,P 0.05）.The days of hospitalization in baloon group was higher than that in embolization group,but the difference was not statistically significant（7.1±1.27d Vs 7.06±1.04d,P 0.05）.After5 months,20%relapse in baloon group and 13.3% in embolization group happened and there was statistically significant difference by comparison（P 0.05）.Complication rates were 26.6% and13.3% respectively in both groups,showing no difference（P 0.05）.Conclusion Balloon block is effective in the treatment of massive hemoptysis.It is valuable to use widely in the clinica1.