超选择性支气管动脉栓塞术在大咯血治疗中的应用  

Role of selective bronchial artery embolization in the management of hemoptysis

作　　者：王平[1] 梁志欣[1] 方向群[1] 孙继萍[1] 徐淑凤[1] 陈良安[1] 

机构地区：[1]解放军总医院呼吸科,北京100853

出　　处：《军医进修学院学报》2008年第3期176-177,共2页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的:探讨超选择性支气管动脉栓塞术在大咯血治疗中的临床应用价值。方法:24例咯血患者使用微导管行超选择性支气管动脉插管,造影确认病变血供后,使用明胶海绵等栓塞剂对病变血管进行栓塞。结果:患者基础病变:支气管扩张13例、肺癌7例、结核1例、血管瘤1例、原因不明咯血2例。栓塞部位:支气管动脉栓塞8例,支气管动脉与胸廓内动脉一同栓塞11例。疗效:即刻止血15例(62.5%),咯血明显减少5例(20.8%),4例(16.7%)再次咯血。超选择性支气管动脉栓塞术治疗大咯血的有效率为83.3%(20/24),复发率16.7%(4/24)。全部病例均无严重并发症发生。结论:超选择性支气管动脉栓塞术治疗大咯血疗效明显,适用于内科治疗无效和无外科手术适应证的大咯血患者。Objective： To retrospectively evaluate the contribution of selective bronchial artery embolization to its management of pulmonary hemoptysis. Methods： Medical record review of patients who had therapeutic bronchial artery embolization admired for the treatment of moderate and massive pulmonary bleeding from 1996 to 2006. Results： A total of 24 patients were admitted. Underlying diseases of these patients were broncbiectasis （13 cases） ,malignancies （4 cases） ,tuberculosis （1 case） ,bemangioma （1 case）,unknown hemoptysis （2 cases）, Among the 24 patients, the original artery of bleeding was identified at bronchial artery in 8 cases, mixed with internal thoracic artery in 11 cases, The initial success rate （ no further bleeding during follow - up） was 62.5% （ 15 cases）. In 5 （20.8%） cases, this therapy reduced bleeding obviously, But the recurrent hemoptysis was found in other 4 （ 16.7% ） patients. Severity complication did not occur in all 24 patients, Conclusion： Hemoptysis signals life - threatening diseases. Selective bronchial artery embolization is a good treatment to control pulmonary hemoptysis and reduces the need for high - risk emergency lung resections.

关 键 词：咯血 支气管动脉 栓塞 

分 类 号：R562.2[医药卫生—呼吸系统]