支气管动脉栓塞术后再咯血原因及治疗对策

The causes and corresponding therapeutic strategies of recurrent hemoptysis after bronchial artery embolization

目的探讨支气管动脉栓塞术(BAE)后再咯血的原因及相应的治疗对策。方法分析389例行支气管动脉栓塞术后发生再咯血的54例患者的咯血原因及治疗结果。结果54例再咯血中,34例为原有病变进展,占63.0%,DSA表现为出现新的出血灶和/或侧支循环形成。20例原因为原有病变血管再通,占37.0%。再次BAE术后治愈47例,占87.0%。结论支气管动脉栓塞术后应积极地治疗基础疾病防止原有病变进展。在支气管动脉栓塞术操作过程中防止漏栓供血动脉,并注意操作技巧,选择适当的栓塞材料。

Objective To evaluate causes and corresponding therapeutic strategies of recurrent hemoptysis after bronchial artery embolization （BAE）. Methods The causes of recurrent hemoptysis after BAE in 389 cases were analyzed. Results Of 54 cases of recurrent hemoptysis, 34 cases were due to progress of original diseases, accounting for 63.0%, which were presented as new bleeding lesions or growth of new branch vessels in DSA. 20 cases of recurrent hemoptysis were due to a recanalization of vessels, accounting for 37%. After a second BAE, 47 cases were recovered accounting for 87.0%. Conclusion The treatment of underlying diseases for the prevention of deterioration after BAE should be implemented actively. Omission of responsible bronchial arteries should be avoided during the process of BAE, and the operation skill and selection of appropriate embolization material should be given attention.