支气管动脉栓塞治疗大咯血的临床应用

Bronchial or intercostal artery embolization for massive hemoptysis

目的探讨支气管动脉栓塞治疗大咯血的临床价值。方法 136例经内科治疗无效的反复咯血患者,咯血病史3～30个月,咯血量为500～1000ml/d,其中肺结核28例,支气管扩张102例,肺癌6例。采用Seldinger技术,行超选择性支气管动脉或肋间动脉栓塞治疗,栓塞材料以明胶海绵、PVA为主,必要时加用弹簧圈进一步栓塞。结果 129例患者1次栓塞成功,7例患者需再次行栓塞治疗,有效率达100%,无严重并发症发生。结论支气管动脉栓塞治疗大咯血是一种安全、有效的治疗方法。

Objective To evaluate the effect of bronchial artery embolization for treatment of massive hemoptysis. Methods Between 2003 and 2009, 136 patients （87 men and 49 women, mean 49.6 years） who presented with massive hemoptysis of 500 to 1000 mL in 24 hours underwent bronchial artery or intercostal artery embolization. The main causes of hemoptysis were tuberculosis （28）, bronchiectasis （102）, and lung cancer （6）. Embolization was performed with particles of gelfoam, PVA and/or coil. Results Of 136 patients, hemoptysis was controlled in 129 patients after one treatment. Seven patients required repeat emboliza tion. The effective rate was 100% with no serious complication. Conclusion Bronchial or intercostal artery embolization is an effective and safe treatment for massive hemoptysis.