支气管动脉栓塞术在治疗大咯血中的应用

Application of bronchial artery embolization in the treatment of massive hemoptysis

目的:探讨支气管动脉栓塞术(BAE)在治疗急性大咯血中的临床应用价值。方法:48例大咯血患者,接受BAE治疗,发病时咯血量大于300ml/24h或100ml/次,其中支气管扩张32例,肺结核9例,肺癌7例。根据选择性支气管动脉造影情况,选择聚乙烯醇微粒,或联合明胶海绵颗粒及弹簧圈进行栓塞。复发者再次行BAE治疗,所有病例随访6～18个月,观察疗效及并发症。结果:48例大咯血患者均无严重并发症发生,1次栓塞43例,2次栓塞5例,总有效率95.8%(46/48),复发率10.4%(5/48)。结论:BAE治疗大咯血安全有效,可成为治疗大咯血的首选方法。

Objective：To evaluate the clinical significance of bronchial artery embolization（BAE）in the manage-ment of massive hemoptysis.Method：Forty-eight patients with massive hemoptysis（300ml of blood in 24hours or 100ml once）were treated with BAE.The causes of hemoptysis included bronchiectasis（32cases）,tuberculosis（9cases）,pulmonary carcinoma（7cases）.After selective bronchial arterial angiography,BAE were performed using polyvinyl alcohol particles alone or in combination with gelatin sponge particles and metal coils.BAE were repeated in the recurrent patients.All patients were followed up for 6to 18months to evaluate the efficacy and complications.Result： All cases of 48patients had no serious complications.Embolization was performed once in 43patients.Recurrence occured in 5patients（10.4%）and the efficiency of BAE was 95.8% （46/48）.Conclusion：BAE is a safe and effective treatment and may be preferred method for acute massive hemoptysis.