联合使用多种栓塞材料行支气管动脉栓塞术治疗急性大咯血的疗效  

Efficacy of bronchial artery embolization with multiple embolic materials for acute massive hemoptysis

作　　者：张明照 李博 秦荣清 张宇博 周兵[1] 万辰宇 胡若宸 ZHANG Mingzhao;LI Bo;QIN Rongqing;ZHANG Yubo;ZHOU Bing;WAN Chenyu;HU Ruochen(Vascular Intervention Center,the Affiliated of Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院介入血管科,310015

出　　处：《浙江医学》2023年第12期1299-1303,共5页Zhejiang Medical Journal

摘　　要：目的探讨联合使用聚乙烯醇(PVA)颗粒、明胶海绵、弹簧圈行支气管动脉栓塞术(BAE)治疗急性大咯血的疗效。方法回顾性分析2019年1月至2022年8月杭州师范大学附属医院介入血管科收治的联合使用多种栓塞材料行BAE治疗的59例急性大咯血患者的临床资料,并对责任血管的分布以及治疗效果进行分析。结果59例患者均成功实施BAE,共栓塞175支咯血责任血管,其中143支(81.71%)为支气管动脉供血,30支(17.14%)为非支气管动脉体循环动脉供血,2支(1.14%)为肺动脉供血。所有患者术后咯血均即刻停止,即刻止血率100.00%。治疗总有效率93.22%(55/59),复发率6.78%(4/59)。术后均未发生脊髓损伤及重要脏器异位栓塞等严重并发症。结论联合使用PVA颗粒、明胶海绵、弹簧圈行BAE治疗急性大咯血安全、高效、复发率低、并发症少。Objective To investigate the effect of bronchial artery embolization(BAE)with PVA pellets,gelatin sponges and spring coil in the treatment of acute massive hemoptysis.Methods The clinical data of 59 patients with acute massive hemoptysis admitted to the Vascular Intervention Center of the Affiliated Hospital of Hangzhou Normal University from January 2019 to August 2022 were retrospectively reviewed.The BAE was performed with multiple embolic materials,including PVA pellets,gelatin sponges,and spring coil.The distribution of responsible vessels and the treatment efficacy were analyzed.Results BAE was successfully performed in all 59 patients with a total of 175 responsible vessels.Of the 175 responsible vessels,143(81.71%)were bronchial arteries,30(17.14%)were nonbronchial systemic arteries(NBSA),and 2(1.14%)were pulmonary arteries.All patients had immediate cessation of hemoptysis after the procedure,and the immediate hemostasis rate was 100.00%.The overall efficacy rate was 93.22%(55/59),and the recurrence rate was 6.78%(4/59).No serious complications such as spinal cord injury and ectopic embolism of important organs occurred after BAE.Conclusion The combined use of PVA pellets,gelatin sponges,and spring coil in BAE for acute massive hemoptysis is safe,efficient,and has a low recurrence rate with few complications.

关 键 词：咯血 支气管动脉栓塞 责任血管 栓塞材料 

分 类 号：R459.7[医药卫生—急诊医学]