2种材料支气管动脉栓塞治疗大咯血的临床分析  

The Clinical Effects of Bronchial Artery Embolization Using PVA and Gelfoam in Massive Hemoptysis

作　　者：陈绿娇[1] 陈义雄[1] 陈建业[1] 李涛[1] 周国英[1] 梁卫明[1] 周卫国[1] 

机构地区：[1]广东医学院附属医院放射科,广东湛江524001

出　　处：《实用放射学杂志》2005年第2期158-160,共3页Journal of Practical Radiology

摘　　要：　　目的　探讨 2种栓塞材料聚乙烯醇(PVA)颗粒和明胶海绵颗粒支气管动脉内栓塞治疗急性大咯血的临床疗效。方法　62例(男 40例,女 22例)临床表现为急性大咯血患者,先行选择性支气管动脉插管造影,再做超选择支气管动脉插管,A组 (32例 )注入PVA颗粒栓塞末梢支气管动脉,再用明胶海绵颗粒栓塞近端支气管动脉。B组 (30例 )单纯用明胶海绵栓塞。结果　A组即刻止血 28例(87. 5% ), 72h内咯血停止 4例 (12. 5% ),有效率 100%;B组即刻止血 25例 ( 83. 3% ), 72h内咯血停止 5例(16. 7% )。2组近期疗效无差别(P>0. 05)。随访 1年,A组复发 2例(6% ),B组复发 9例(30% ),复发率差异显著(P<0. 01)。2组均未见严重不良反应。结论　PVA及明胶颗粒支气管动脉栓塞治疗大咯血安全、有效,前者不易复发,值得临床推广应用。Objective To study bronchial arteries embolization with polyvinyl alcohol(PVA) or Gelfoam in the massive hemoptysis.Methods Patients in group A(n=32)and group B(n=30) with acute massive hemoptysis were performed selective bronchial arteries angiogaphy and superselective bronchial arteries embolization (group A using PVA and group B using Gelfoam).Results Massive hemoptysis in group A were complete controlled. Immediate control of hemoptysis was achieved in 28 patients, marked reduce in bleeding was seen in 4 patients . The effective rate was 100%. In group B, immediate control of hemoptysis was achieved in 25 patients, marked reduce in bleeding was seen in 5 patients . All patients were followed for one year. The recurrence rate was 6% in group A and 30% in group B(P<0.01). None of severe adverse reaction was occurred. Conclusion Superseletive bronchial artery embolization with PVA is an effective and safe procedure for controlling massive hemoptysis.

关 键 词：咯血 支气管动脉栓塞 治疗性 放射学 介入性 

分 类 号：R441.7[医药卫生—诊断学] R815[医药卫生—临床医学]