选择性支气管动脉栓塞术治疗大咯血25例临床分析

Clinical value of selective bronchial arterial embolism in treatment of 25 hemoptysis

目的针对支气管动脉栓塞术治疗大咯血的临床分析。方法对25例大咯血患者(支气管扩张18例、肺结核3例、肺癌1例、支气管动静脉畸形2例、原因不明咯血1例)行选择性支气管动脉栓塞治疗。其中支气管动脉栓塞22例,使用明胶海绵颗粒加明胶海绵条栓塞15例,使用明胶海绵条与聚乙烯醇颗粒联合栓塞2例。使用明胶海绵颗粒与钢圈联合栓塞5例。结果栓塞后即刻止血19例,咯血量明显减少3例。1例复发患者再次行栓塞治疗后未再出现咯血。有效率为88%(22/25)。全部病例无并发症发生。结论支气管动脉栓塞术是治疗肺大咯血的一种安全、有效、微创的方法。

Aim To analyze the clinical value of bronchial artery embolization in treatment of massive hemoptysis. Method 25 patients with hemoptysis including bronchiectasis in 18 cases, pulmonary tuberculosis 3 cases, bronchial carcinoma 1 case, bronchial arteriovenousmalformation 2 cases and unknown hemoptysis 1 cases underwent embolized treatment of bronchial arteriography. Of them, bronchi- al artery embolization were performed in 22 cases. In the total 25 cases, gelatin sponge particles （GSP）and gelatin sponge strip was used in 15 cases, gelatin sponge strip and polyvinyl alcohol（PVA） in 2 cases, GSP and coil in 5 cases. Result The hemoptysis was immediately stopped in 19 cases, remarkable improvement 3 cases after operation. The one recurred case accepted re -embolization and hemoptysis had been well controlled. The effective rate was 88% （22/25）. There was not any severe complication in all the patients. Conclusion Bronchial arterial embolism is a safe, effective and less invasive method in treatment of massive hemoptysis. It can be recommended to the non -surgical treatment patients.