采用不同栓塞剂行支气管动脉栓塞治疗大咯血的疗效

目的 探讨明胶海绵（GS）颗粒和聚乙烯醇（PVA）颗粒支气管动脉内栓塞治疗急性大咯血的临床疗效.方法 48例急性大咯血患者,先行选择性支气管动脉插管造影,然后用导管插管至出血支气管动脉分支,A组（21例）用GS颗粒栓塞,B组（31例）用PVA颗粒栓塞.结果 A组21例患者,栓塞后即止血18例（85.7%）,72小时止血2例（9.5%）,止血有效率95.2%,B组31例患者栓塞后即止血26例（83.9%）,72小时止血5例（16.1%）,止血有效率100%,A、B两组有效率差异无统计学意义（P＞0.05）;随访1年,A组复发5例（23.8%）,B组复发1例（3.2%）,1年复发率差异有统计学意义（P＜0.01）.结论 支气管动脉栓塞术是治疗大咯血的有效方法,应用PVA颗粒为栓塞剂,安全有效,不易复发,临床疗效显著.

Effect of bronchial artery embolization in treating large hemoptysis with gelatin sponge and polyvinyl alcohol

Objective To evaluate the effect of bronchial artery embolization(BAE) with gelatin sponge(GS) or polyvinyl alcohol(PVA) in the acute large hemoptysis.Methods Forty-eight patients with acute large hemoptysis were performed selective bronchial arteries angiogaphy,with catheter BAE.The patients in group A(n=21) received GS and group B(n=31) PVA.Results In group A,immediate control of hemoptysis was achieved in eighteen patients((85.7%)),marked reduction in bleeding was seen in two patients((9.5%)),the effective rate for bleeding was(95.2%).In group B,immediate control of hemoptysis was achieved in twenty-six patients((83.9%)),marked reduction in bleeding was seen in five patients((16.1%)),the effective rate for bleeding was 100%,and no significant difference appeared between the two groups(P>(0.05)).All the patients were followed for one year.The recurrence was five patients((23.8%)) in group A and a patient((3.2%)) in group B,with significant difference(P<(0.01)).Conclusion BAE is effective and safe for management of serious hemoptysis,superseletive bronchial PVA is an effective and safe procedure for controlling large hemoptysis.