氰基丙烯酸正丁酯与栓塞微球治疗大咯血对比研究  

Bronchial artery embolization for the treatment of massive hemoptysis: a comparison study between N-butyl-2-cyanoacrylate and embosphere

作　　者：严倩[1] 向军益[2] 周兵[2] 

机构地区：[1]杭州师范大学附属医院急诊医学科,310015 [2]杭州师范大学附属医院介入血管科,310015

出　　处：《介入放射学杂志》2016年第12期1054-1057,共4页Journal of Interventional Radiology

摘　　要：目的对比α-氰基丙烯酸正丁酯（NBCA）胶和三丙烯明胶微球（Embosphere）在支气管动脉栓塞术（BAE）治疗肺部大咯血中的安全性和有效性。方法收集2010年1月至2014年12月采用BAE术治疗并有完整随访资料的肺部大咯血患者，其中NBCA胶治疗43例（NBCA组），栓塞微球治疗80例（栓塞微球组），对比两组患者BAE技术成功率和临床止血率、并发症发生率、咯血复发率，并对临床结果进行分析。结果NBCA组和栓塞微球组BAE技术成功率分别为95．3％（41／43）、96．3％（77／80）（P=0．809）；临床止血率分别为93．O％（40／43）、92．5％（73／80）（P=0．639）；并发症发生率分别为41．7％（18／43）、35．0％（28／80）（P=0．452），绝大部分为术后胸痛；咯血复发率分别为16．3％（7／43）、28．8％（23／80）（P〈0．05）；两组中各有1例发生脊髓功能障碍，经内科治疗后康复。两组患者Kaplan—Meier生存分析比较结果显示，差异有显著统计学意义（χ^2=6．523，P=0．041）。结论与栓塞微球相比，NBCA胶治疗肺部大咯血的安全性和有效性相当，但能够降低远期复发率。Objective To compare the safety and efficacy of N-butyl-2-cyanoacrylate （NBCA） with those of embosphere in treating acute massive hemoptysis with bronchial artery embolization （BAE）. Methods A total of 123 patients with massive hemoptysis, who were treated with BAE during the period from January 2010 to December 2014 and who had complete follow-up data, were enrolled in this study. NBCA was employed in 43 patients （NBCA group）, and embosphere was adopted in 80 patients （embosphere group）. The technical success rate of BAE, the clinical hemostasis rate, complication rate and recurrence rate of hemoptysis were compared between the two groups, and the clinical results were analyzed. Results The technical success ratesof BAE in NBCA group and in embosphere group were 95.3% （41/43） and 96.3% （77/ 80） respectively, （P=0.809）; the clinical hemostasis rates of NBCA group and embosphere group were 93.0% （40/43） and 92.5% （73/80） respectively, （P=0.639）; the complication rates of NBCA group and embosphere group were 41.7% （18/43） and 35.0% （28/80） respectively, （P=0.452）. Most of the complications were postoperative chest pain. The recurrence rates of hemoptysis of NBCA group and embosphere group were 16.3% （7/43） and 28.8%（23/80） respectively, （P〈0.05）. One patient in each group developed spinal cord dysfunction, and both patients recovered after internal medication. Kaplan- Meier survival analysis revealed that significant difference in the recurrent rate of hemoptysis existed between the two groups （χ^2=6.523, P= 0.041 ）. Conclusion For the treatment of massive hemoptysis, BAE using NBCA carries the same safety andeffectiveness as BAE using embosphere does, but BAE using NBCA can decrease the long-term recurrence rate.

关 键 词：Α-氰基丙烯酸正丁酯 栓塞微球 咯血 脊髓功能障碍 

分 类 号：R459.7[医药卫生—急诊医学]