选择性支气管动脉栓塞术治疗大咯血疗效分析  

Effect of selective bronchial artery embolization for patients with mass hemoptysis

作　　者：袁小亮[1] 宋军福[1] 许玉华[1] 张芝辉[1] 邹斌[1] 王雪梅[1] 宗佩兰[1] 

机构地区：[1]江西省胸科医院介入治疗中心,江西南昌330008

出　　处：《临床荟萃》2010年第1期22-24,共3页Clinical Focus

摘　　要：目的回顾性分析选择性支气管动脉栓塞术（sBAE）治疗咯血的价值。方法对41例（43例次）大咯血患者行SBAE。术后随访6～12个月．平均]0．2个月。结果41例患者行SBAE43次，插管成功率96．9％（42j43），即刻止血35例（85．4％），5例栓塞后仍有少量咯血，显效12．2％（5/41）。1例栓塞后无效，总有效率97．6％。分别随访6～12个月（平均10．2个月），一次性治愈33例（82．5％）。7例复发，复发率17．5％。采用明胶海绵单纯拴塞和联合栓塞与采用明胶海绵和带毛钢圈双重栓塞，术后患者均无严重并发症发生。肺结核咯血患者复发率高于支气管扩张症，但差异无统计学意义（P〉0．05）。结论SBAE治疗咯血是一种安全、止血迅速、疗效确切的治疗措施，尤其适合临床内科保守治疗效果差或不能手术的大咯血患者。Objective To retrospectively analyze the value of selective bronchial artery embolization（SBAE） for patients with mass hemoptysis. Methods Forty-three times of SBAE were performed for 41 cases with hemoptysis. All cases were performed witb percutaneous transfemoral catheterization and followed up for 6 12 months（median 10.2 months）. Results The success rate of SBAEwas 96.9%（42/43）.Hemoptysis control was achieved in 97.6%（40/41）. SBAE resulted in an immediate cessation of hemoptysis in 35 of 41 cases（85.4%）. Partial control rate was 12.2% （5/ 41） ,ineffective case was only one. One time cure without recurrence was 33 cases（82.5%） and recurrence was 7 cases （17.5%）. During 6 months＇ to 12 months＇ follow up period, the recurrent rate of SBAE for pulmonary tuberculosis was higher than bronchiectasis,however,there were no statistical difference between them（ P 〉0.05）. Conclusion SBAE is a safe and effective way to control hemoptysis. SBAE should be adopted as early as possible especially when conservative treatment is not effective and operational surgery is unsuitable for the patients with mass hemoptysis.

关 键 词：肺疾病 咯血 支气管动脉 栓塞 治疗性 

分 类 号：R563.61[医药卫生—呼吸系统]