介入治疗大咯血的支气管造影与栓塞  

Broncho-arteriography and embolization of interventional therapy in hemoptysis

作　　者：包明红[1] 梅晓冬[1] 张学彬[1] 

机构地区：[1]安徽医科大学附属省立医院呼吸科,230001

出　　处：《临床肺科杂志》2008年第2期185-186,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的讨论介入治疗的支气管造影与栓塞对不同的肺部疾病所引起的大咯血的应用价值。方法所有59例病人均采用SELDINGER技术经股动脉穿刺插管行数字减影血管造影（DSA），明确病变部位或出血动脉后，采用永久性栓塞剂灭菌真丝线段或／和金属钢圈，经支气管动脉或／和肋间动脉行拴塞术。结果59例病人有31例咯血立即停止，即时止血率达52．5％，21例咯血在1周内渐止，4例病人咯血次数及咯血量均有不同程度的减少，介入治疗近期有效率达88．14％（52／59）。在1～4年的随访中，良恶性病变3个月内复发率分别为6．45％（2／31）、42．86％（12／28），1年内复发率分别为78．57％（22／28），9．68％（3／31）。结论介入治疗对肺部大咯血近期疗效确切，但远期疗效与疾病的性质，血供情况，病灶大小及栓塞剂的选用密切相关。Objective To explore clinical value of broncho - arteriography and embolization in hemoptysis. Methods 59 patients with hemoptysis were examined with DSA. After bleeding arteries defined, the embolized treatment of bleeding bronchial or/and arteries were performed with sterilized silk lengths or/and coils in all of them. Results Active bleeding was stopped at once in 31 cases, fresh bleeding was stopped gradually in one week in 21 cases, and the frequent and quantity of hemoptysis were reduced in different degree in 4 cases. The interventional effective rate was 88. 14% （52/59） in the followed-up of 1 to 4 year interval. In the 3-month follow-up, the recurrent rates were 6. 45 % （2/31） and 42.86% （ 12/28 ） respectively for the patients with non - carcinomas hemoptysis and carcinomas hemoptysis, and in one year follow-up, the rates were g. 68% （3/31） and78.57% （22/28） respectively. Conclusion The efficacy of interventional therapy on hemoptysis is apparent, but the long-term successful rate is associated with nature and scope of pathology, supplying arteries and the selection of the embolizating agents.

关 键 词：血管造影 栓塞 大咯血 治疗 

分 类 号：R56[医药卫生—呼吸系统]