摘要
目的探讨应用明胶海绵(GS)和聚乙烯醇(PVA)颗粒动脉栓塞术治疗肺咯血治疗效果及复发原因分析。材料和方法对85例肺咯血患者(单纯性支气管扩张21例、肺结核及结核性支扩48例、肺癌6例、肺曲菌病3例、矽肺2例、肺脓肿1例、肺囊肿1例、原因不明3例)行动脉栓塞术止血。栓塞剂分别采用GS、PVA颗粒,其中单纯应用GS25例,单纯应用PVA颗粒32例,联合应用GS、PVA颗粒28例。全部病例随访6个月以上。结果即时止血72例(84.7%),一次性治愈44例(51.8%),显效和好转37例(43.5%),无效4例(4.7%)。25例复发(29.4%),肺结核及结核性支扩占20例,二次栓塞9例,治愈5例。一次性治愈44例中单纯性支气管扩张17例,肺结核及结核性支扩17例,肺癌2例(即时止血率100%,另外4例晚期肺癌因其他原因在6月内死亡),肺曲菌病2例,肺脓肿1例,矽肺2例,肺囊肿1例,原因不明2例;单纯应用GS治愈8例(治愈率32%),单纯应用PVA颗粒治愈18例(治愈率56.3%),联合应用GS、PVA颗粒治愈18例(治愈率64.3%)。结论动脉栓塞术治疗肺咯血疗效显著。单纯应用GS治愈率<单纯应用PVA颗粒治愈率<联合应用GS、PVA颗粒治愈率。肺结核及结核性支扩疗效相对较差,复发率相对较高。
Purpose:To analyze the effect of treatment and the cause of recurrence of artery embolization by using gelfoam and ivalon to control pulmonary hemoptysis.Materials and Methods:Artery embolization was performed on85patients including pure bronchiectasis(n=21),tuberculosis and tuberculous bronchiecˉtasis(n=48),pulmonary carcinoma(n=6),aspergillosis(n=3),silicosis(n=3),lung abscess(n=1),lung cysts(n=1),unknown hemoptysis(n=3).The hemostatic agents included Gelfoam(GS)and Ivalˉon.25cases were embolized with GS,32cases were embolized with PVA,28cases were embolized with GS and PVA.All patients were followed over six months.Results:Immediate cessation of hemoptysis(n=72,84.7%),once cure without recurrence(n=44,51.8%),having significant effect(n=37,43.5%),invalid(n=4,4.7%).25cases recured massive bleeding(29.4%),in which20cases had tuˉberculosis and tuberculous bronchiectasis.9cases were embolized again and5cases were cured.Among cases of once cure without recurrence:pure bronchiectasis(n=17),tuberculosis and tuberculous bronchiectasis(n=17),pulmonary carcinoma(n=2),aspergillosis(n=2),silicosis(n=2),lung abscess(n=1),lung cysts(n=1),unknown hemoptysis(n=2).Cured cases and rate of artery embolization by GS,PVA,GS+PVA were8(32%),18(56.3%),18(64.3%).Conclusion:The effect of artery embolization to control pulmonary hemoptysis is evident.Cured cases and rate:GS<PVA<GS+PVA.The effect on paˉtients with tuberculosis and tuberculous bronchiectasis is less evident,and they are prone to recurring.
出处
《中国医学计算机成像杂志》
CSCD
2005年第1期58-62,共5页
Chinese Computed Medical Imaging