电解可脱性弹簧圈介入治疗大咯血疗效分析

Clinical analysis of endovascular embolization with guglielmi detachable coil for massivehemoptysis

目的探讨应用电解可脱性弹簧圈（guglielmi detachable coil，GDC）在治疗大咯血中的经验及疗效。方法回顾性分析2005-06-2011-01我院介入科行介入栓塞治疗的72例大咯m患者，其中支气管扩张29例，肺结核35例，肺癌5例，肺动静脉畸形3例，按栓塞材料不同分为GDC栓塞（29例）、聚乙烯醇颗粒（PVA）栓塞（26例）、明胶海绵栓塞（17例）3组，进行，检验，评价其疗效。结果67例术后即刻止血，5例咯血明显减少，经内科治疗48h内咯血停止。术后随访6-18个月，GDC组3例复发，有效率89．66％，PVA组3例复发，有效率88．46％，明胶海绵组8例复发，有效率52．94％，3组有效率比较差异有统计学意义（P〈0．05）。结论应用GDC栓塞术治疗大咯血具有安全、创伤小、疗效好等优点，是一种行之有效的方法。

To explore the experience and curative effect of guglielmi detachable coils（ GDC ） for massive hemoptysis. Methods From June 2005 to January 201 l, a retrospective analysis was made in 72 cases of massive hemoptysis with interventional embolization from interventional radiology department ill our hospital. There were 29 cases with bronchiectasis, 35 cases tuberculosis, 5 cases lung cancer, 3 cases puhnonary arteriovenous malformation. Based on the embolic material, all the patients were divided into GDC group, PVA group, and gelatin and sponge group. Results 67 eases of patients with embolization stopped completely hemoptysis. 5 patients of hemoptysis were significantly reduced by medical treatment of hemoptysis stopped within 48 hours. All the patients were followed up 6 18 months. In GDC group 3 cases recurred, the effective rate was 89.66% ; in PVA group 3 cases recurred, the effective rate was 88.46% ; and in gelatin and sponge group 8 cases recurred, the effective rate was 52.94%. There were statistical differences in effective rate among three groups （ P 〈 0.05 ）. Conclusion Interventional embolization with GDC for massive hemoptysis is safe, effective, less trauma, and the curative effect is satisfactory.