支气管动脉栓塞术治疗60例大咯血的临床回顾分析  

Clinical retrospective analysis of 60 cases of mssive haemoptysis treatd by bronchial artery embolization

作　　者：刘萍[1] 王丰[1] 敖伟[1] 姚本波 Liu Ping;Wang Feng;Ao Wei;Yao Benbo(Department of respiratory and criticalmedicine,Zigong Fouth People’s Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院呼吸与危重症医学科,四川自贡643000

出　　处：《医药前沿》2020年第24期18-20,共3页Journal of Frontiers of Medicine

摘　　要：目的:为保障大咯血患者生命安全并提高其生活质量,探讨支气管动脉栓塞术治疗60例大咯血的临床疗效。方法:选取我院2013年2月1日-2019年6月30日收治的60例大咯血患者,经常规内科保守治疗无效或尚未完全控制咯血或咯血反复,予以支气管动脉造影后行选择或超选择插管,对支气管动脉远端细小分支、分支及主干进行逐级密实栓塞治疗。术后记录患者手术疗效、并发症、复发率等情况。结果:一次栓塞成功者52例,2次栓塞成功者3例,栓塞后出血量明显减少的是3例肺癌患者,栓塞后效果欠佳最终转胸外科手术治疗的有1例,栓塞后6d大咯血窒息死亡者有1例,无术中死亡。栓塞术后即时止血率93.8%,近期复发率5%,中远期复发率0。结论:支气管动脉栓塞术是治疗大咯血的一种微创、安全性高、疗效理想并确切的一种治疗方法,可应用于临床。Objective To ensure the safety of life and improve the quality of life of patients with massive hemoptysis,the clinical effect of bronchial artery embolization on 60 patients with massive hemoptysis was discussed.Method 60 cases of patients with massive hemoptysis were selected from February 1,2013 to May 31,2018 in our hospital,through routine internal medicine conservative treatment was ineffective or not completely controlled hemoptysis or repeated hemoptysis,bronchial arteriography was followed by selection or hyperselection intubation,the distal branches,branches and main branches of bronchial arteries were treated with stepwise dense of embolization.Postoperative outcomes,complications and recurrence rates were recorded.Result In this group,52 cases were successfully treated with one embolization,3 cases with two embolization,After hemoptysis embolization of 3 cases of lung cancer,the blood loss was significantly reduced,1 case with poor outcome after embolization and finally with thoracic surgery,1 case died of massive hemoptysis asphyxia 6 days after embolization,and there were no deaths during the operation.The immediate hemostasis rate after embolization was 93.8%,the short-term recurrence rate was 5%,and the long-term recurrence rate was 0.Conclusion Bronchial artery embolization is a safe,effective and rapid treatment for massive hemoptysis,clinical application is recommended.

关 键 词：大咯血 支气管动脉栓塞术 回顾分析 

分 类 号：R562.22[医药卫生—呼吸系统]