支气管动脉栓塞术治疗肺咯血疗效分析

目的分析支气管动脉栓塞术治疗肺咯血的临床价值。方法对87例咯血患者(支气管扩张46例、肺结核18例、肺癌15例、支气管动静脉畸形2例、原因不明咯血6例)行选择性支气管动脉或肋间动脉栓塞治疗。其中支气管动脉栓塞78例,肋间动脉栓塞6例,支气管动脉与肋间动脉一同栓塞3例。2例使用同轴微导管行超选择栓塞,使用明胶海绵微粒栓塞85例,使用明胶海绵微粒与聚乙烯醇颗粒联合栓塞2例。全部病例随访12～18个月。结果栓塞后即刻止血58例,咯血量明显减少19例。于栓塞后1周、2周、1个月分别有5例、3例、2例复发。10例复发患者再次行栓塞治疗后未再出现咯血。有效率为89%(77/87)。全部病例无并发症发生。结论支气管动脉栓塞术是治疗肺咯血的一种安全、有效、微创的有效方法。

The Effect of Bronchial Arterial Embolization in Treating Massive Hemoptysis

Objective To analyse the clinical value of bronchial artery embolization in treatment of massive hemoptysis.Methods 87 patients with hemoptysis included bronchiectasis in 46 cases,pulmonary tuberculaosis in 18 cases,bronchial carcinoma in 15 cases,bronchial arteriovenous malformation in 2 cases and unknown hemoptysis in 6 cases underwent embolized treatment of bronchial arteriography or intercostal arteriography.Of them,bronchial artery embolization were performed in 78 cases,intercostal artery embolization were done in 6 cases,both embolization of bronchial artery and intercostal artery were in 3 cases,2 cases underwent superselective embolization with coaxial microcatheter.In the total 87 cases,gelatin sponge particles(GSP) alone was used in 85 cases,GSP and polyvinyl alcohol(PVA) were used in 2 cases.All the patients were followed up for 12~18 months.Results The hemoptysis was immediately stopped in 58 cases, remarkable improvement were 19 cases after operation. Recurrence of hemoptysis was found in five, three and two cases at one, two and four weeks respectively after embolization. All of the ten recurred cases accepted re-embolization and hemoptysis had been well controlled. The effective rate was 89%(77/87). There was not any severe complication in all the patients.Conclusion Bronchial artery embolization is a safe, effective and less invasive method in treatment of massive hemoptysis. It can be recommended to the non-surgical treatment patients.