大咯血介入动脉栓塞治疗及疗效评价

目的探讨动脉栓塞治疗大咯血的临床疗效。方法对56例内科非手术治疗无效的大咯血患者。经股动脉插入导管，栓塞相关支气管动脉或供血动脉。栓塞材料以明胶海绵为主，部分病例采用PVA颗粒和钢圈栓塞。在造影中，仔细观察影像，避免误栓脊髓动脉。术后随访观察止血疗效及并发症。结果56例术后即刻止血达到100％，1个月内咯血复发2例（3．6％）；1-2．5年间复发3例。出现脊髓损伤症状1例（1．8％）。结论介入治疗大咯血安全有效，应为治疗的首选方法。

Efficacy Evaluation of Intra-arterial Embolization Therapy in Massive Hemoptysis

Objective To evaluate clinical success rate of intra-arterial embolization therapy for massive hemoptysis and its complications. Methods Fifty-six patients with massive hemoptysis, who were responseless to non-operaive therapy, were treated with intra-arterial embolization. The procedure was performed via a common femoral artery to embolize the bronchial or feeding artery. The embolic agents included gelfoam for most cases and PVA particle and metallic coil for some cases. All the angiograms were carefully scrutinized for fear that spinal arteries were inadvertently embolized. Most of the cases were followed up. The effect, recurrence rate and complications were observed. Results Immediate control of hemoptysis was achieved in all the cases （ 100% ）. Recurrence of hemoptysis occurred in 2 cases （3.6. % ） in 1 month, and 3 cases between 1 -2.5 years. Transverse myelitis occurred in 1 case （ 1.8% ）. Conclusion Interventional therapy （ i. e. intra-arterial embolization） is an effective and safe method. It should be considered as the first choice for patients with massive hemoptysis.