特发性支气管扩张伴咯血患者的介入治疗疗效及复发危险因素分析  

Efficacy of bronchial artery embolization for hemoptysis in patients with idiopathic bronchiectasis and related risk factors for re-currence

作　　者：邓旖 郭晓华[2] 胡晓钢[2] 王佳敏 DENG Yi;GUO Xiaohua;HU Xiaogang;WANG Jiamin(不详;School of Medicine,Shaoxing University,Shaoxing 312000,China)

机构地区：[1]绍兴文理学院医学院,312000 [2]金华市中心医院肿瘤与血管介入科

出　　处：《浙江医学》2024年第8期851-855,共5页Zhejiang Medical Journal

摘　　要：目的评估支气管动脉栓塞术治疗特发性支气管扩张伴咯血的安全性、有效性并探讨复发的危险因素。方法回顾性收集2020年1月至2023年3月金华市中心医院住院接受支气管动脉栓塞术治疗的108例特发性支气管扩张患者的临床资料,根据出院后是否出现二次咯血将其分为复发组和非复发组,并通过多因素Cox回归分析咯血复发的危险因素。结果108例患者均成功实施支气管动脉栓塞术,共发现403支责任血管。105例患者术后24 h止血,临床成功率为97.2%。出院后中位随访时间为13(8.0,24.8)个月,40例患者出院后咯血复发,咯血复发率为37.0%。多因素Cox回归分析显示,非首次咯血是术后复发的独立危险因素(HR=1.964,95%CI:1.018~3.792,P=0.044)。所有患者均未出现脑梗死、截瘫等严重并发症。结论支气管动脉栓塞术对于特发性支气管扩张伴咯血患者是一种安全、高效的治疗手段,非首次咯血是术后复发的独立危险因素。Objective To analyze the safety and efficacy of bronchial artery embolization(BAE)for treatment of hemoptysis in patients with idiopathic bronchiectasis and related risk factors of recurrence.Methods The clinical data of 108 idiopathic bronchiectasis patients with hemoptysis who underwent BAE treatment in Jinhua Central Hospital from January 2020 to March 2023 were retrospectively analyzed.Multivariate Cox regression analysis was used to investigate the risk factors related to the recurrence of hemoptysis after BAE.Results The technical success rate of BAE procedure was 100.0%,and a total of 403 responsible blood vessels were discovered.Among 108 patients 105 had instant termination of hemorrhage after BAE,with a hemostasis rate of 97.2%.During the median follow-up time of 13(8.0,24.8)months,recurrence of hemoptysis occurred in 40 patients with a recurrence rate of 37.0%.Multivariate Cox regression analysis revealed that non-first bleeding was an independent risk factor for recurrence of hemoptysis(HR=1.964,95%CI:1.018-3.792,P=0.044).Conclusion BAE is safe and effective for treatment of hemoptysis in patients with idiopathic bronchiectasis,and the non-first bleeding is a risk factor for the recurrence of hemoptysis after BAE.

关 键 词：支气管扩张 咯血 支气管动脉栓塞术 非支气管性体动脉 

分 类 号：R562.22[医药卫生—呼吸系统]