3种不同支气管动脉栓塞方法治疗大咯血的疗效比较

目的 探讨3种不同支气管动脉栓塞术治疗大咯血的临床价值，观察不同的栓塞物质和栓塞方式对大咯血治疗的临床效果及与并发症的关系。方法 93例大咯血病例，26例行单纯明胶海绵栓塞，30例行夹心面包法栓塞，37例行四重夹心面包法栓塞。所有病例随访6～24个月。结果 3组病例近期（6个月内）有效率：单纯明胶海绵栓塞92％（24／26），夹心面包法栓塞100％（30／30），四重夹心面包法栓塞100％（37／37）；远期疗效（6-24个月）单纯明胶海绵栓塞和夹心面包法栓塞均有复发病例，四重夹心面包法栓塞无复发病例。结论 四重夹心面包法支气管动脉栓塞术是治疗大咯血的一种简便、创伤小，且高效的治疗手段。

A comparison of the effects of the 3 methods of bronchial artery embolization for treatment of massive hemoptysis

Objective To study the clinical value of 3 methods of bronchial artery embolization for the treatment of massive hemoptysis, and to observe healing effect and complication after different methods and embolic materials. Methods Selective bronchial artery embolization was performed in 93 patients with massive hemoptysis, among them 26 were embolized with simple gelfoam particles, 30 patients with sandwich bronchial artery embolization, and 37 patients with fourfold sandwich bronchial artery embolization. All patients were followed up for six to twenty-four months. Results The recent efficiency rates of three groups were as follows: simple gelfoam particles 92%(24/36), sandwich bronchial artery embolization 100%(30/30), fourfold sandwich bronchial artery embolization 100%(37/37). There was recrudescence in patients with treatment of simple gelfoam particles and sandwich bronchial artery embolization, but no recrudescence was found in patients treated with fourfold sandwich bronchial artery embolization. Conclusion Fourfold sandwich bronchial artery emblization is one of simple and highly effective methods with minimal trauma in treating massive hemoptysis.