大咯血介入治疗疗效评价

目的对内科治疗无效的大咯血患者行供血动脉栓塞,探讨操作技术细节,栓塞剂的选择,对病例长期随访并进行疗效分析。方法对50例内科保守治疗无效危急生命的大咯血患者行介入法供血动脉栓塞,其中男24例,女26例,平均年龄48岁;支气管扩张20例,肺结核18例,慢性肺部感染6例,肺癌2例,不明原因4例。结果所有病例都成功实施了供血动脉栓塞,术后除1例无效外均出血停止,无严重并发症发生。术后随访2年8例支扩合并感染和8例结核患者再发出血。结论清晰的供血动脉显示,规范的导管操作,合理的栓塞剂选择是手术成功、减少并发症的关键。肺原发疾病的进展,侧枝血管的建立、开放是复发出血的主要因素。

Efficacy analysis of interventional therapy for the treatment of massive hemoptysis

Objective Massive hemoptysis patients who had no effect to internal therapy were selected for feeding artery embolization. To investigate the operation technique,embolization agent selection and efficacy after Long time follow up. Methods The interventional feeding artery embolization therapy was performed in 50 massive hemoprysis patients who had no effect to internal therapy. The patients (male 24 cases, female 26 cases, average age 48 years) include bronchiectasis 20cases,pulmonary tuberculosis 18cases,chronic pulmonary infection 6cases,lung cancer 2cases and 4cases without accurate pathogeny. Results The feeding artery was performed successfully in all the patients. The bleeding was controlled in all the patients with one exception and no complication occurred. 8 cases bronchiectasis and 8 cases pulmonary tuberculosis had hemoptysis recurrence during 2 years follow up. Conclusion Clear feeding artery appearance, regulate operation and reasonable embolization agents selection were key factors to operation success and complication reduction. The developing of pulmonary primary diseases, the forming and opening of collaterial artery were main reasons for bleeding reoccurrence.