选择性支气管动脉栓塞治疗大咯血48例临床分析

目的探讨选择性支气管动脉栓塞（BAE）治疗大咯血的临床价值。方法48例大咯血患者经选择性支气管动脉造影后对病变动脉用明胶海绵（GS）颗粒和聚乙烯醇（PVA）颗粒进行栓塞止血,当支气管动脉有脊髓分支或与肋间动脉共干时,用微导管超选择性支气管动脉插管。结果双侧支气管动脉栓塞15例,左支气管动脉栓塞14例,右支气管动脉栓塞19例;其中12例采用超选择性支气管动脉病变支插管栓塞;治愈42例,显效4例,无效2例。总有效率95.8%,治愈率87.5%,未出现严重栓塞并发症。结论支气管动脉栓塞术治疗大咯血是一种有效、快速、微创、相对安全的方法。

Clinical analysis of selective bronchial artery embolization for the treatment of hemoptysis

Objective To evaluate the effects of selective bronchial artery embolization in the treatment of hemoptysis（BAE）. Methods Selective bronchial artery embolization were performed in 48 patients with hemoptysis after the site of bleeding or the abnormal arteries were identified by arteriography. Particles of gelatin sponge（GS） and polyvinyl alcohol（PVA） were used separately as embolic agents, and superselective bronchial artery embolization were performed with a coaxial micro-catheter inserted into the bronchial artery in 12 patients while forming the common trunk with the spinal artery or intercostal artery. Results Among 48 patients, 15 bilateral bronchial arteries, 14 left bronchial arteries and 19 right bronchial arteries were embolized, and superselective BAE were performed in 12 patients. Of 48 patients, 42 of them recovered completely, no active bleeding within 24 hours, no recurrent bleeding during long-term follow-up, 4 of them partially relieved, the success rate was 95.8%, long-term cumulative hemoptysis non-recurrence rate was 87.5%, no severe complications was observed. ConcLusion Selective bronchial artery embolization is an effective way in solving massive hemoptysis for its real time hematichesis, minimal invasion and safety.