咯血介入治疗后近期再出血的原因分析

目的 探讨急性大咯血介入栓塞治疗后1周内再次出血的原因.方法 回顾性分析经急诊介入治疗大咯血患者56例,均经股动脉穿刺行支气管动脉、肋间动脉及胸廓内动脉、胸廓外动脉、膈动脉等血管造影或/和栓塞术.结果 本组患者介入术后1周内再次出血6例,其中原发性肺癌栓塞后再出血2例,支气管扩张1例,肺结核1例,食管癌术后1例,食管癌放疗后1例,并再次行支气管动脉、肋间动脉及胸廓内外动脉、膈动脉等相关血管造影栓塞术.结论 介入术前应用血管收缩药物、肺脏供血动脉多样化、病变范围广、栓塞材料的选择不合适、造影图像质量欠清晰等均导致大咯血介入栓塞治疗后近期再出血.

Analysis of the causes of recurrent hemoptysis after interventional treatment

Objective To investigate the causes of recurrent hemoptysis one week after interventional treatment.Methods 56 patients with massive hemoptysis were included in this study.All patients underwent emergent interventional therapy, including angiography and embolization therapy of bronchial artery, intercostal artery, internal thoracic artery, external thoracic artery and phrenic artery via femoral artery puncture.Results 6 cases had rebleeding within one week after interventional therapy,including 2 cases with primary lung cancer,1 case with bronchiectasis,1 case with pulmonary tuberculosis,1 case with esophageal cancer after surgery,1 case with esophageal cancer after radiotherapy.Then, these patients once again underwent angiography and embolization therapy of bronchial artery,intercostal artery,internal thoracic artery,external thoracic artery and phrenic artery.Conclusion The use of vasoconstrictive drugs before intervention, diversification of pulmonary feeding artery, wide range of lesions, inappropriate embolic material and poor image quality can lead to recurrent hemoptysis after interventional treatment.