Embosphere微球在介入治疗支气管扩张大咯血中的应用  

Application of Embosphere microsphere in interventional therapy for bronchiectasic massive hemoptysis

作　　者：沈炜[1] 黄祥忠[1] 高峰[1] 任冬青[1] 包凯沪[1] 郭新春[1] 顾建平[2] 

机构地区：[1]东南大学医学院附属江阴医院介入科,江苏江阴214400 [2]南京医科大学附属南京医院南京市第一医院介入科,江苏南京210000

出　　处：《中国临床研究》2014年第10期1174-1177,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨Embosphere微球联合明胶海绵经导管支气管动脉栓塞（TBAE）治疗支气管扩张大咯血的临床疗效。方法回顾性分析2009年1月至2013年4月东南大学医学院附属江阴医院介入科TBAE术治疗的65例支气管扩张大咯血患者的临床资料,根据所用的不同栓塞材料分成为明胶海绵组（15例）、Embosphere微球组（24例）及二联材料组（明胶海绵＋Embosphere微球,26例）,对其疗效进行分析。结果 65例患者共栓塞责任动脉120支,随访6～12个月,明胶海绵组7例复发,有效率53.33%（8/15）;Embosphere微球组2例复发,有效率91.67%（22/24）;二联组2例复发,有效率92.31%（24/26）。Embosphere微球组、二联组总有效率均高于明胶海绵组（P均〈0.05）,Embosphere微球组与二联组总有效率比较差异无统计学意义（P〉0.05）。3组患者并发症主要是胸闷和胸痛,经对症处理后缓解,均无脊髓损伤等严重并发症发生。结论采用Embosphere微球或Embosphere微球联合明胶海绵行TBAE治疗支气管扩张急性大咯血安全、有效。Objective To evaluate the clinical efficacy of Embosphere microsphere combined with gelatin sponge in transcatheter bronchial arterial embolization（ TBAE） for the treatment of bronchiectasic massive hemoptysis. Methods The clinical data of 65 patients with bronchiectasic massive hemoptysis treated by TBAE between January 2009 and April 2013 in the department of interventional radiology of Jiangyin Hospital Affiliated to Medical College of Southeast University were retrospectively analyzed. The patients were divided into three groups according to used embolic material： gelatin sponge group（ 15 cases）,embosphere microsphere group（ 24 cases） and bigeminal materials（ gelatin sponge plus embosphere microsphere） group（ 26 cases）. The therapeutic effect in three groups was analyzed. Results A total of 120 responsible arteries were embolized in the 65 cases. All the patients were followed up from 6 to 12 months. The recurrent cases were respectively seen in 7,2,2 cases in gelatin sponge group,embosphere microsphere group and bigeminal group,and the overall effective rate were 53. 33%（ 8 /15）,91. 67%（ 22 /24） and 92. 31%（ 24 /26） in gelatin sponge group,embosphere microsphere group and bigeminal group,respectively. The overall effective rates in embosphere microsphere group and bigeminal group were all higher than that in gelatin sponge group（ all P〈0. 05）,while there was no statistical difference on the overall effective rate between embosphere microsphere group and bigeminal group（ P〉0. 05）. The main complications in the three groups were chest distress and chest pain but were remitted by expectant treatment. No spinal cord injury occurred in all the three groups. Conclusions TBAE using embosphere microsphere or embosphere microsphere combined with gelatin sponge is a safe and effective method for treating acute bronchiectasic massive hemoptysis.

关 键 词：大咯血 支气管扩张 栓塞 Embosphere微球 明胶海绵 

分 类 号：R562.22[医药卫生—呼吸系统]