支气管-肋间动脉联合栓塞治疗肺结核大咯血

目的探讨支气管-肋间动脉联合栓塞治疗肺结核大咯血的临床价值。方法19例肺结核大咯血患者,行选择性支气管动脉和肋间动脉造影并对病变血管用2 mm手术丝线段进行栓塞。结果19例咯血患者,共栓塞58支出血血管。其中行支气管动脉-肋间动脉联合栓塞17例,单独栓塞支气管动脉和肋间动脉各1例。17例联合栓塞患者24h内咯血停止16例,即刻止血率94.2%（16/17）;1周内咯血停止1例;近期有效率100%（17/17）。2例单独栓塞支气管动脉或肋间动脉者止血无效。36个月内复发2例。无严重栓塞相关并发症发生。结论支气管-肋间动脉联合栓塞是治疗肺结核大咯血的有效手段,具有止血迅速、复发率低及安全性高的优点。

Combined bronchial-intercostal arterial embolization for treating heavy hemoptysis from pulmonary tuberculosis

Objective To evaluate the clinical value of combined bronchial-intercostal arterial embolization(CBIAE) for treating heavy hemoptysis from pulmonary tuberculosis. Methods After the selective arteriography,arterial embolization with 2 mm silk thread was performed in 19 patients with heavy hemoptysis from pulmonary tuberculosis. Results In 19 patients,58 responsible arteries were embolized.CBIAE was performed in 17 patients,and only bronchial arterial embolization was performed in 1 patient and only intercostal arterial embolization in another patient.Bleeding stopped within 24 hours in 16 patients of the 17 patients treated with CBIAE(94.18%) and bleeding stopped within one week in another patient.The total effective rate of CBIAE was 100%(17/17).Only bronchial or only intercostal arterial embolization was ineffective in 2 patients.Recurrence of hemoptysis was found in 2 patients in 3 to 6 months.No serious complication related to embolization occured. Conclusion CBIAE is a fast,safe and effective way for treating heavy hemoptysis from pulmonary tuberculosis.