肺结核与支气管扩张症咯血的支气管动脉栓塞治疗

目的 探讨肺结核和支气管扩张症咯血的支气管动脉差异与栓塞方法。方法 临床治疗肺结核咯血25例，支气管扩张症咯血15例，行选择性支气管动脉造影并对病变血管用明胶海绵行栓塞术，32例加用弹簧圈。结果 40例咯血，共对63支有出血征象的动脉行BAE，即时止血率92．5％（37／40）。肺结核咯血以体-肺血管分流多见，支气管扩张症以血管增粗、扭曲多见。结论 肺结核咯血BAE宜注重小血管栓塞，支气管扩张症咯血BAE宜以主干栓塞为主。

Management of massive hemoptysis in pulmonary tuberculosis and bronchiectasis by bronchial arterial embolization

Objective To probe into the angiographic signs and the variations of bronchial arteries for pulmonary tuberculosis or bronchiectasis with massive hemoptysis.Methods 25 patients with pulmonary tuberculosis and 15 patients suffered from bronchiectasis accompanied by massive hemoptysis were undertaken bronchial arterial embolization(BAE).All patients were embolized with gelfoam including 32 with spring coils in addition. Results 63 arteries demonstrated angiographic signs of hemoptysis in 40 patients.The immediate stanching rate was 92.5%(37/40). The bronchopulmonary shunt formation sign shown by angiograph was the major feature of tuberculosis(P=(0.0528)) and the enlarged tortuous arteries in bronchiectasis were more to be demonstrated than in tuberculosis(P<(0.05)).Conclusions The BAE for patients with tuberculosis ought to te peformed in the smaller arteries.BAE for patients with bronchiectasis should to be taken in the trunk of arteries.