支气管动脉介入治疗的栓塞剂选择和应用

Selection and application of embolic agent in the treatment of hemoptysis with bronchial artery interventional therapy

目的:探讨肺咯血支气管动脉栓塞治疗中,栓塞剂的选择和应用对治疗效果和安全性的影响。方法:本文47例中,支气管扩张30例、肺癌11例、肺结核6例,采用单用明胶海绵颗粒5例、明胶海绵颗粒+超液化碘油7例、聚乙烯醇8例、聚乙烯醇+明胶海绵颗粒11例、聚乙烯醇+明胶海绵颗粒+超液化碘油16例五组进行对比研究,分析讨论。结果:五组病例中,单用明胶海绵颗粒组有3例复发;明胶海绵颗粒加超液化碘油组2例复发;聚乙烯醇组1例复发;聚乙烯醇+明胶海绵颗粒、聚乙烯醇+明胶海绵颗粒+超液化碘油组均无复发。结论:支气管动脉介入栓塞治疗中的栓塞剂选择中,单用明胶海绵易复发,单用聚乙烯醇不如聚乙烯醇+明胶海绵颗粒、聚乙烯醇+明胶海棉+超液化碘油栓塞的方法安全持久。

Objective To study the selection and application of embolic agent, the therapeutic results and safety of bronchial artery intervention in the treatment of hemoptysis. Methods Fortyseven cases of lung cancer and bronchiectasis with hemoptysis received transbronchial artery interventional therapy. The embolic agents used were gelfoam particles in 5 cases （group 1）, gelfoam particles ＋hyperliquified iodized oil in 7 cases （group 2）,polyvinyl alcohol in 8 cases （group 3）, polyvinyl alcohol ＋ gelfoam particles in 11 cases （group 4）, polyvinyl alcohol ＋ gelfoam ＋ hyperliquified iodized oil in 16 cases （group-5）, respectively. The therapeutic results were analyzed and compared. Results Hemoptysis recurred in 3 cases in group 1, in 2 cases in group 2 and in 1 case in group 3 whereas there was no recurrence in the remaining 2 groups. Conclusion In the treatment of hemoptysis with bronchial artery intervention, the better therapeutic results could be achieved by combined use of embolic agents for instance polyvinyl alcohol ＋ gelfoam, or polyvinyl alcohol ＋ gelfoam ＋hyperliquified iodized oil. The results are more sustained and safe than using single embolic agent alone.