支气管动脉栓塞术治疗大咯血的疗效分析

目的 :探讨支气管动脉栓塞术治疗大咯血的疗效。方法 :36例大咯血患者用明胶海绵颗粒行支气管动脉栓塞。患者肺部基础病变包括 :支气管扩张 13例 ,肺结核 11例 ,肺癌 9例 ,肺脓肿 1例 ,隐源性咯血 2例。结果 :2 9例即刻止血 (80 .6 % )。在 2年的随访中 ,术后 15d内复发大咯血并窒息死亡者 4例 ,另外 4例复发咯血者 ,3例再次行BAE治疗。支气管动脉栓塞术后因复发而行手术治疗者 2例。因此 ,2年随访总的有效率和复发率分别为 83.3%和 2 2 .8%。主要的并发症为自限性的短暂胸痛和发热。结论 :支气管动脉栓塞术是大咯血的一种安全、微创、高效的治疗方法

Analysis of Effect of Bronchial Arterial Embolization in Treating Massive Hemoptysis

Objective: To evaluate the curative effects of bronchial arterial embolization (BAE) in the treatment of massive hemoptysis. Methods:36 patients with massive hemoptysis underwent BAE by using gelfoam particles through transfemoral anterial approach. The underlying diseases included 13 cases of bronchiectasis, 11 cases of pulmonary tuberculosis, 9 cases of pulmonary carcinoma, 1 case of lung abscess, and 2 cases of hemoptysis with occult origin. Results: The immediate clinical success, defined as hemoptysis control, was obtained in 29 patients( 80.6% ). The follow up time was more than 2 years in 33 patients. Among them, 4 patients suffered from recurrent massive hemoptysis and died of airway obstruction within 15 days after BAE. A reembolization was performed in 3 of 4 patients experienced recurrent hemoptysis. In addition, 2 patients with reembolization were operated after embolization. So the overall effective rate and recurrence rate for 2 years were 83.3% and 22.8% respectively. Self limited transient thoracic pain and low grade fever were the remarkable complications of the procedure. Conclusion: BAE is a safe, less invasive and effective method in the treatment of massive hemoptysis.