合并肺结核对支扩咯血血管内栓塞疗效的影响

目的分析是否合并肺结核对支气管扩张（支扩）咯血患者血管内栓塞术成功率及栓塞术后复发率的影响。方法收集2006年1月～2009年12月在湘雅二医院、益阳市中心医院行血管内栓塞治疗的支扩咯血病例52例,其中单纯支扩38例、支扩合并肺结核14例。用独立样本t检验分析是否合并肺结核对支扩患者栓塞术后复发率的影响;分析病因、病变范围以及供血血管数目与患者血管内栓塞术成功率及栓塞术后复发率的相关性及相互关系采用多因子逐步回归分析,P0.05为有显著性差异。结果 1、单纯支气管扩张血管内栓塞治疗术后复发率为10.5%,显著低于支扩合并肺结核患者42.8%的复发率。（t值为-2.211,P值为0.041）;2、对于单纯支气管扩张患者,手术成功率（y）与病变范围（x）存在线性关系,其回归方程为y=-0.155x＋3.187;对于合并肺结核的患者,手术成功率（变量y）与供血血管数目（变量x）存在线性关系,其回归方程为y=-x＋4。结论 1、单纯支扩患者血管内栓塞治疗后的复发率显著低于支扩合并肺结核者;2、对于支扩合并肺结核患者,病变范围越广、供血血管数目越多、胸膜改变情况越严重,其手术成功率越低。

Tuberculosis affects the embolization's results for hemoptysis caused by bronchiectasis

Objectives To analyze whether tuberculosis affects the embolization＇s effective ratio and the recurrence rates of post-embolization for hemoptysis caused by bronchiectasis.Methods From Jan.1 2006 to Dec.30 2009,52 cases of patients with bronchiectasis hemoptysis undergone endovascular embolization were collected.Among of them,38 cases were simple bronchiectasis,14 cases complicated with tuberculosis.Independentsample t test and multiple factor step wise regression analysis were used,and P〈0.05 was defined as significance difference.Results 1.The mean of recurrence rate of simple bronchiectasis of post-embolization（10.5%,4/38） was lower than that of bronchiectasis complicated with tuberculosis（42.8%,6/14）（t=-2.211,and P=0.041）.2.For bronchiectasis,there was linear correlation between the embolization＇s effective ratio and the extent of disease,the regression equation was y=-0.155x＋3.187;For bronchiectasis complicated with tuberculosis,there was linear correlation between the embolization＇s effective ratio and the amount of blood-supply vessels,the regression equation was y=-x＋4.Conclusions 1.The recurrence rate of post-embolization for hemoptysis caused by simple bronchiectasis is much lower than that of complicated with tuberculosis.2.For bronchiectasis complicated with tuberculosis,the broader extent of disease,the more the amount of blood-supply vessels,the more serious the pleura adhesion,the lower the effective ratio.