支气管动脉栓塞治大咯血38例临床研究

目的观察支气管动脉栓塞术对大咯血患者的临床疗效。方法 2000年至2008年因大咯血住院患者,经胸部影像学检查或纤维支气管镜、支气管动脉造影明确诊断的患者行支气管动脉栓塞术。结果共38例患者,男26,女12例,年龄56±9岁,反复咯血31例,支气管扩张27例,支气管肺囊肿4例,不明原因4例,肺结核3例。支气管动脉造影均表现为血管畸形,给予支气管动脉栓塞治疗35例出血立即减少,1周内完全消失。随访1年,复发大咯血2例。治疗后3例短时间内轻微胸痛,2例肩痛,3例伴胸闷,3例腹股沟皮下淤血,对症处理后短期内好转。结论支气管动脉栓塞术对治疗急性或反复发生的大咯血非常有效,可以使患者避免外科手术的风险,对复发患者再次治疗也安全有效。

Clinical study of bronchial artery embolization in the treatment of 38 patients with mass hemoptysis

Objectives To investigate the effectiveness of bronchial arteriography and bronchial artery embolization（BAE） in the treatment of 38 patients with mass hemoptysis.Methods A review of clinical experience to evaluate the demographics,clinical presentation,radiographic studies,bronchoscopy,and complications of bronchial arteriography and BAE,and 38 patients in hospital from 2000 to 2008.Results 38 patients underwent bronchial arteriography.There were 26 men and 12 women with a mean age of 56±9 years.Hemoptysis was the most common indication in 31 patients（81.6%）.Hemoptysis was caused by bronchiectasis（27 patients）,bronchopulmonary cyst（4 patients）,pulmonary tuberculosis（3 patients）.The cause could not be identified in 4 patients.Bronchial arteriography revealed hypervascularity（all patients）.BAE was attempted in 38 patients,completed,and unsuccessful.Overall,embolization sessions were performed with a total of 38 arteries embolized.Control of hemoptysis was observed in 35 patients（92%） for 1 week.Rebleeding occurred within 1 year in 2 patients.The complications of embolization included thoracalgia in 3 cases,omalgia in 2 patients,dyspnea in 3 patients,and 3 subjects with sug（g） illation at groin,but taking a favorable turn after treatment.Conclusions BAE is a useful therapy to control both acute and chronic hemoptysis.BAE may help to avoid surgical risk in patients who are not good surgical candidates.Should hemoptysis recur in these patients,repeat embolization can be performed safely.