选择性支气管动脉双重栓塞治疗咯血的远期疗效分析

目的评价不同的材料和操作程序，对支气管动脉栓塞治疗咯血的远期疗效的影响。方法７２例咯血患者，分组接受选择性支气管动脉双重栓塞和单纯明胶海绵栓塞治疗。２９例患者选择支气管动脉双重栓塞时，首程采用明胶微粒（０．５ｍｍ×０．５ｍｍ）、高渗氯化钠和红霉素的混合物栓塞末梢血管，次程以明胶颗粒（１ｍｍ×１ｍｍ）栓塞主干及１～２级分支血管，４３例患者选择单程明胶海绵栓塞治疗。结果两组患者经过治疗后及随访２～４．８年，止血治愈率和总有效率分别为：双重栓塞组８３％、１００％，单纯明胶海绵栓塞组６１％、９５％。两组病例止血治愈率相比较，差异有显著性（Ｐ＜０．０５）。结论选择性支气管动脉双重栓塞能明显提高治疗咯血的远期疗效

The long term effect of double embolization of bronchial artery on patients with hemoptysis

OBJECTIVE: To investigate the long-term effect of bronchial arterial embolization with different material and procedure on patients with hemoptysis. METHOD: Seventy two cases were divided into two groups, one received the double embolization of bronchial artery, the other group used single gelfoam embolization. In double embolization group, the mixture containing gelfoam microspheres (0.5 mm x 0.5 mm), erythromycin and high osmalality sodium chloride were firstly used to embolize the terminal vessels, the gelfoam particle (1 mm x 1 mm) was then used to embolize the main trunk of bronchial artery. RESULT: After 2-4.8 years following up, it turned out that the cure rate and general effectiveness were: the double embolization group 83%, 100% respectively, the single gelfoam embolization group 61%, 95%. By comparison, there were significant difference on cure rate between these two groups(P < 0.05). CONCLUSION: The bronchial arterial double embolization will increase the long-term effect obviously on patients with hemoptysis.