肺出血患者经支气管动脉栓塞止血治疗

Analysis of Effect of Bronchial Arterial Embolization in Treating Massive Hemoptysis

目的探讨肺出血患者经支气管动脉栓塞(BAE)止血的疗效。方法 74例大量肺出血患者,支气管扩张30例,肺结核21例,肺癌20例,肺脓肿1例,隐源性咯血2例。所有患者经支气管动脉行PVA颗粒栓塞治疗。结果经2年随访,本组病例的有效率为90.5%。74例大量肺出血患者中,术后即刻止血73例(98.6%)。经2年的随访发现术后15 d内复发大咯血死亡者4例,其中3例还再次行BAE治疗。此外,2例复发患者而行手术治疗。结论肺出血患者经支气管动脉栓塞止血的疗效确切。

Objective To evaluate the curative effects of bronchial arterial embolization （BAE） in the treatment of massive hemoptysis. Methods 74 patients with massive hemoptysis underwent BAE by using PVA particles through transfemoral anterial approach. The underlying diseases included 30 cases of bronchiec- tasis,21 cases of pulmonary tuberculosis,20 cases of pulmonary carcinoma, 1 case of lung abscess, and 2 cases of hemoptysis with occult origin. Results The overall effective rate for 2 years were 90.5 %. The immediate clinical success,defined as hemoptysis control,was obtained in 73 patients（98.6% ）. The follow-up time was more than 2 years in 73 patients. Among them,4 patients suffered from recurrent massive hemoptysis and died of air way obstruction within 15 days after BAE. A reembolization was performed in 3 of 4 patients experienced recurrent hemoptysis. In addition,2 patients with reembolization were operated after embolization. Conclusion BAE is a safe,less invasive and effective method in the treatment of massive hemoptysis.