三丙烯微球联合明胶海绵动脉双重栓塞治疗大咯血的效果评价  

The effective evaluation of the double embolization therapy of the trisacryl gelatin microspheres combined gelatin sponge on the massive hemoptysis

作　　者：张万壮[1] 史继国[2] 田素红[1] 李秀芝[3] 李秀霞[4] 宋敬华[5] 刘培光[6] 张瑞凤[5] 

机构地区：[1]河北联合大学附属医院介入医学科,河北省唐山市063000 [2]河北联合大学附属医院放射科,河北省唐山市063000 [3]河北联合大学附属医院核医学科,河北省唐山市063000 [4]河北联合大学附属医院神经内科,河北省唐山市063000 [5]河北联合大学附属医院感染性疾病科,河北省唐山市063000 [6]河北联合大学附属医院心血管内科,河北省唐山市063000

出　　处：《中国综合临床》2014年第6期645-648,共4页Clinical Medicine of China

摘　　要：目的：评价三丙烯微球联合明胶海绵颗粒行支气管动脉栓塞（BAE）治疗急性大咯血的临床效果。方法对100例临床诊断为大咯血的患者，行超选择性支气管动脉栓塞，研究组（50例）采用三丙烯微球联合明胶海绵颗粒栓塞支气管动脉，对照组（50例）单纯采用明胶海绵颗粒栓塞支气管动脉。所有病例随访12个月以上，并对临床效果进行对比分析。结果研究组栓塞后即刻止血42例（84.0％，42/50），72 h 止血7例（14.0％，7/50），止血有效率98.0％（49/50）；对照组栓塞后即刻止血41例（82.0％，41/50），72 h 止血8例（16.0％，8/50），止血有效率98.0％（49/50），两组止血有效率比较差异无统计学意义（P 〉0.05）；随访1年以上，研究组复发3例（6.12％，），对照组复发15例（30.61％），1年复发率比较差异有统计学意义（χ2=9.801，P 〈0.01）；两组 BAE 治疗后均无严重并发症发生。结论BAE 术是治疗大咯血的有效方法，应用三丙烯微球联合明胶海绵颗粒动脉双重栓塞治疗大咯血，安全有效，复发率低，临床效果显著。Objective To evaluate the clinical effect of therapy of the trisacryl gelatin microspheres combinee the gelatin sponge particle on embolize the bronchial artery in acute massive hemoptic patients. Methods One huneree cases with massive hemoptysis were selectee as our subjects ane eivieee into control ane research group（n = 50 for each group）. Patients in control group were given only gelatin sponge particle,ane in research group were given the trisacryl gelatin microspheres combinee the gelatin sponge particle to embolize the bronchial artery. All cases were followee up for more than 12 months. Ane the effect of therapy was recoreee. Results In research group,42 cases（84. 0% ,42 / 50）were got the bleeeing stop immeeiately after embolization,7 cases in 72 h（14. 0% ,7 / 50）,ane the effective rate of hemostasis was 98. 0%（49 / 50）. In the control group,41 case（82. 0% ,41 / 50）were got the stop bleeeing immeeiately,8 cases in 72 h（16. 0% , 8 / 50）,ane the effective rate of hemostasis was 98. 0%（49 / 50）. There was no statistic eifference between two groups（P 〉 0. 05）. After more than one year follow-up,3 cases（6. 12% ）were reoccurree in the therapy group ane 15 cases（30. 61% ）was in the control group. The eifference was significant between two groups after surgery for one year（ χ2 = 9. 801,P 〈 0. 01 ）. There was no serious complication in patients of two groups. Conclusion The operation of BAE is effective therapy for the massive hemoptoe,ane it is provee to be a safe,effective ane lower rate of recurrence approach of the trisacryl gelatin microspheres combinee the gelatin sponge particle for eouble embolzation the bronchial artery.

关 键 词：咯血 三丙烯微球 明胶海绵颗粒 支气管动脉栓塞 

分 类 号：R56[医药卫生—呼吸系统]