大咯血介入治疗中两种不同栓塞方法的对比研究

Study on comparison of two different embolic methods in treatment with massive hemoptysis

目的:研究与探讨单纯明胶海绵和多种栓塞材料联合栓塞治疗大咯血的安全性和临床疗效。方法:114例大咯血患者随机分成两组,单纯明胶海绵栓塞57例;弹簧圈和明胶海绵、PVA颗粒和明胶海绵联合栓塞57例。介入栓塞病变支气管动脉,术后随访疗效。结果:明胶海绵栓塞组出血完全停止41例,明显减少7例,总有效率84.2%。联合栓塞组出血完全停止48例,明显减少6例,总有效率94.7%,两组间差异有统计学意义。术后3～12个月内随访,单纯明胶海绵随访37例,其中复发6例,复发率16.2%;联合栓塞组随访39例,复发2例,复发率5.1%。结论:支气管动脉栓塞治疗大咯血是一种安全、有效、操作简便、损伤小的治疗方法,多种材料联合栓塞有效率高,复发率低,且近、中期效果明显优于单纯明胶海绵栓塞。

Objective To discuss the safety and clinical efficacy about united embolism of pure gelatin sponge and various embolic materials in the treatment with massive hemoptysis.Method Total 114 massive hemoptysis patients were randomly divided into two groups,57 cases in the group of pure gelatin sponge;the other 57 cases in the group of the united embolism of coils with gelatin sponge and PVA particle with gelatin sponge,with intervene embolic bronchial artery diseases,and were followed up for efficacy.Results In the group of pure gelatin sponge,41 patients′ bleeding was completely terminated and 7cases were significantly reduced and the total efficiency was 84.2%.In the group of the united embolism,48 patients′ bleeding was completely terminated and 6 cases were significantly reduced and the total efficiency was 94.7%,and the differences between the two groups were significant,followling up 3 to 12 months,6 recurrence of 37 cases in the group of pure gelatin sponge,the recurrence rate was 16.2% while 2 recurrence of 39 cases in the group of the united embolism,the recurrence rate was 5.1%.Conclusion Bronchial artery embolization for treatment with massive hemoptysis is safe,effective,easy to operate and less damage,and united embolism by various embolic materials has high effective rate and low recurrence rate which is better than pure gelatin sponge in the recent and medium efficacy.