支气管动脉栓塞治疗大咯血

目的：探讨支气管动脉栓塞(BAE)治疗大咯血的临床应用价值。方法：57例大咯血患者支气管动脉插管造影明确病变血管后，经导管缓慢注入明胶海绵颗粒栓塞出血血管，18例患者使用微导管超选择性BAE治疗。结果：出血完全停止44例，出血量减少9例，无效4例，有效率92．9％。结论：支气管动脉栓塞治疗大咯血是一种安全、有效、操作简便、损伤小的治疗方法。     

支气管动脉栓塞术治疗大咯血

目的：探讨支气管动脉栓塞术对各种原因所致大咯血的治疗效果。方法：7例患包括结核性支扩2例，肺癌1例，支气管扩张症4张，咯血史3天－2年，全部病例术前经胸部平片、CT诊断。术中，行选择性支气管动脉造影，确认病变部位后经导管送入栓塞材料，其中3例使用金属弹簧圈，4例使用明胶海棉。结果：全部患于栓塞前，咯血量50－1000ml/天，经栓塞后即刻止血。2例偶有痰中带血，随访1－14个月，无大咯血复发及并发症。结论：使用支气管动脉栓塞术是治疗大咯血的有效方法，成功率高，创伤小，临床效果满意。     

支气管动脉栓塞治疗急性大咯血

急性大咯血是一种严重的急症，如抢救不及时，可危及患者的生命，传统内科止血疗法效果不十分理想且容易复发。我们采用支气管动脉栓塞方法，成功抢救了３例大咯血患者，取得满意效果，现报道如下。材料与方法男１例，女２例，年龄２８～５２岁。２例确诊为支气管扩张，患...     

支气管动脉栓塞治疗大咯血

目的 评价支气动脉栓塞治疗大咯血的疗效及影响因素。方法 对32例急性或顽固性大咯血（咯血量大于300ml）患者单纯采用明胶海绵栓塞支气管动脉止血。原发疾病包括肺结核18例，支气管扩张9例，肺癌5例。全部病例于栓塞治疗后经随访6-48个月。结果 31例（97%）即时止血，2例（6%）近期（2-3周）内复发，6例（18.7%）中远期（2月以上）复发，1例12h后急性大咯血窒息死亡。结论 单纯用明胶海绵栓塞支气管动脉治疗急性或顽固性大咯血疗效满意。近期复发与侧支循环有关，中远期复发可能与原发病及明胶海绵的吸收有关。     

支气管动脉栓塞治疗肺大咯血

目的　探讨支气管动脉栓塞治疗大咯血的方法及疗效。方法　对 36例大咯血或长期反复咯血的病人用明胶海绵颗粒栓塞支气管动脉。 36例病人中 ,单侧 31例 ,双侧 5例。肺癌 1 7例 ,支气管扩张 8例 ,肺结核 1 1例。先行支气管动脉造影 ,确定出血血管后 ,用明胶海绵颗粒栓塞 ,直到支气管动脉闭塞为止。结果　即刻止血 31例 ,出血完全控制。 5例咯血明显减少 ,内科治疗后咯血完全停止。随访 3月～ 5年 ,再出血 2例。结论　支气管动脉栓塞是治疗大咯血的有效方法 ,效果确切 ,止血迅速     

无水乙醇栓塞支气管动脉治疗大咯血

目的：探讨支气管动脉栓塞治疗大咯血的材料及方法。方法：分析24例大咯血病人的临床资料，具体操作方法。结果：24例大咯血病人中，支气管动脉明显增粗、扩张、迂曲，行支气管动脉栓塞术后咯血即刻停止，有效率达100％，随访观察12—48个月，平均28个月，22例无复发，占98％，2例因新生肿瘤血管复发，占2％。结论：无水乙醇栓塞支气管动脉治疗大咯血效果好，对原发性肺癌有积极的治疗作用。     

不同支气管动脉栓塞材料治疗大咯血的对照研究

目的 探讨采用不同支气管动脉栓塞(BAE)材料治疗大咯血的疗效及相关并发症.方法 46例大咯血患者根据栓塞材料不同分为对照组、观察组,对照组12例采用明胶海绵栓塞,观察组34例采用聚乙烯醇(PVA)颗粒(必要时辅以弹簧圈)栓塞,评估术后疗效及脊髓损伤、胸痛等并发症发生情况.结果 对照组有效率91.67％,观察组有效率8...     

大咯血的支气管动脉栓塞治疗

大咯血为肺科常见急症之一,当咯血量大于300 ml/24 h时,临床上称之为大咯血.其中约3%的患者虽经内科多种治疗仍不能控制,外科手术治疗同样具有较高的病死率,且并发症发生率高.我院近年来对12例顽固性大咯血患者进行了14次支气管动脉栓塞(BAE)术,取得满意疗效,现结合文献报道分析如下.     

Massive hemoptysis due to Mycobacterium fortuitum infection controlled with bronchial artery embolization - a case report

We reported a case of first reported pulmonary infection due to Mycobacterium fortuitum (M. fortuitum) with massive hemoptysis, successfully treated by bronchial artery embolization (BAE). A 78-year-old male was admitted to our hospital complaining of massive hemoptysis. A biochemical examination and DNA/DNA hybridization revealed M. fortuitum in the culture of his sputum. He was treated by BAE, and antituberculous agents and levofloxacin. The patient remains well without recurrence more than one and a half years after the admission.     

选择性支气管动脉栓塞治疗急性大咯血

目的评价选择性支气管动脉栓塞(SBAE)治疗急性大咯血的疗效。方法34例急性大咯血病人,实行SBAE治疗。结果追踪观摩8～16个月,除2例再发大咯血外,未见严重并发症和胸、肋间、咽喉痛及吞咽困难等明显副反应。结论SBAE是目前较好的急性大咯血治疗方法。     

Successful bronchial artery embolization using hydrogel coils for hemoptysis during extracorporeal membrane oxygenation

A 58-year-old woman with bronchiectasis presented with massive hemoptysis and severe respiratory failure, which required long-term extracorporeal membrane oxygenation with continuous heparin infusion. Bronchial artery embolization using hydrogel coils, which provide a greater volume occlusion than bare platinum coils, was performed; hemoptysis stopped and she fully recovered. No recanalization was observed on follow-up computed tomography angiography 2 months postbronchial artery embolization, and there had been no recurrence of bleeding at the time of this report (at least 6 months). Although continuous anticoagulation during extracorporeal membrane oxygenation might hinder complete vessel occlusion by metallic coils or induce early recanalization (because the homeostatic mechanism of coils depends on the patient''s coagulability), our experience showed that bronchial artery embolization using hydrogel coils was effective and safe. Additionally, this case presents a successful example of anticoagulation management for patients with hemoptysis on extracorporeal membrane oxygenation who undergo bronchial artery embolization using coils.     

选用不同栓塞剂经支气管动脉栓塞的安全性分析

支气管动脉解剖变异较大,常见的有左右支气管动脉共干,支气管动脉与肋间动脉、纵隔动脉,甚至食管动脉共干,加上肿瘤或结核等病变侵蚀、破坏,使得体循环与肺循环血管之间形成瘘。因而支气管动脉栓塞(bronchial artery embolization,BAE)可引起食管气管瘘,异位栓塞,甚至永久性截瘫等严重并发症。本研究着重分析根据插管水平、DSA表现及疾病性质等综合因素,灵活选用不同栓塞材料,目的是增加BAE安全性。我科自1999年6月-2006年3月,共行BAE治疗56例患者,均未出现截瘫等严重并发症,现报道如下。     

Visualization of left bronchial-to-coronary artery communication after distal bronchial artery embolization for bronchiectasis

We present a 44-year-old woman in whom a bronchialto-coronary artery communication via the conus branch was discovered after distal bronchial artery embolization with gelatin sponge for hemoptysis. If this bronchial-to-coronary artery anastomosis, not visible prior to embolization, had been inadvertently embolized, the patient could have developed a myocardial infarction. To reduce the likelihood of a serious complication, the possibility of this anastomosis should be kept in mind and angiography should be repeated before attempting proximal bronchial artery embolization.     

支气管动脉栓塞治疗大咯血的远期疗效分析

目的 探讨支气管动脉栓塞术治疗大咯血的远期疗效及影响疗效的因素.方法 对89例肺结核、5例肺癌、2例支气管扩张症所致大咯血共96例患者行支气管动脉栓塞术治疗,术后进行为期1～6年的追踪观察,对咯血有无复发、复发的时间、复发的原因、相应的治疗及效果进行了统计,采用生存分析的寿命表法对咯血控制率进行分析.结果 94例(97.9%)成功施行了支气管动脉栓塞术,术后即刻停止咯血.术后30 d、90 d、1年及2年的咯血控制率分别为93.6%(88/94)、86.2%(81/94)、81.9(77/94)及78.7%(74/94).术后30 d内咯血复发9例,复发的主要原因是漏栓和血管再通.30 d后咯血复发5例,90 d后复发2例,复发的主要原因与非支气管动脉体循环侧支循环形成、肺内病灶进展以及继发感染有关.结论 支气管动脉栓塞术在治疗肺结核咯血时疗效确切.防止漏栓、加主干双重栓塞、注重治疗病因、预防感染有助于提高支气管动脉栓塞术治疗大咯血的远期疗效.     

致命性大咯血的支气管动脉栓塞治疗

目的:探讨支气管动脉栓塞术治疗致命性大咯血的价值。方法:34例致命性大咯血患者用明胶海绵颗粒行支气管动脉栓塞。按治疗方式分为2组,支气管动脉逐级间歇性完全栓塞20例(A组),单纯支气管动脉栓塞者14例(B组)。结果:总有效率为82.4%(28/34),总复发率为29.4%(10/34)。A组较B组疗效好、复发率低(P<0.05)。主要的并发症为自限性短暂的胸痛和发烧。结论:支气管动脉栓塞术是致命性大咯血的一种安全、微创、高效的治疗方法。     

Bronchial artery embolization for hemoptysis: Immediate and long-term results

The purpose of this study was to evaluate the immediate and long-term results in 63 patients who underwent transarterial embolization for control of hemoptysis. Overall immediate success rate was 86.1%. At long-term follow-up 50% of patients showed complete remission, 22% partial remission, and 28% recurrent hemoptysis. Hemoptysis remained controlled for a mean of 22 months and a median of 14 months. The long-term results among four disease groups differed substantially. Patients with bronchiectasis showed the best results, followed by those with idiopathic disease and with inflammation; patients with neoplasm showed the worst results.