支气管动脉栓塞治疗支气管扩张大咯血的技术探讨

目的:探讨支气管动脉栓塞(BAE)治疗支气管扩张大咯血的疗效。方法:31例支气管扩张大咯血患者,选择性支气管动脉造影明确咯血病灶后,对靶血管用明胶海绵颗粒及小条进行栓塞治疗,其中11例同时加用弹簧钢圈行多重栓塞治疗。所有病例门诊随访。结果:31例患者BAE术后30例咯血完全停止,即时止血率96.77%(30/31)。3例在栓塞术后1周内复发大咯血,1例再次行BAE治疗后咯血停止,2例改行手术治疗,近期复发率9.68%(3/31)。中、远期复发少量咯血2例,复发率为6.45%(2/31),总有效率93.55%(29/31)。结论:支气管动脉栓塞术治疗支气管扩张大咯血是一种安全、高效、简便、损伤小的治疗方法,采用多重栓塞可有效降低复发率。

Treatment of Massive Bronchiectasis Hemoptysis by Bronchial Artery Embolization

Objective:To investigate the efficiency of bronchil arterial embolization(BAE) in the treatment of massive bronchiectasis hemoptysis(MBH).Methods:Thirty-one cases of MBH were subjected to selective bronchial arteriography,and all cases were embolized with gelfoam to the target artery,including 11 cases received the combined treatment of gelfoam and spring coils embolization.All cases were followed up in out-patient clinic.Results:MBH was completely controlled in 30 cases immediately affter BAE with the rate of instant hemostasis being 96.77%.MBH recurred in 3 cases within one week after BAE with the short-term recurrence rate being 9.68%(3/31):one patient had re-embolization and hemoptysis was completely controlled,and 2 were converted to surgical operation.The middle-and long-term recurrence was 9.68% and 6.45% respectively.The total effective rate was 93.55%.Conclusion:BAE is a safe,effective,simple and less invasive method.It is the best choice to treat MBH.The repeated embolization can effectively reduce recurrence.