大咯血的介入治疗

The interventional management of massive hemoptysis

目的:探讨支气管动脉栓塞治疗大咯血的治疗方法及临床价值。方法:对17例大咯血患者采用同轴微导管技术超选择支气管动脉栓塞术(SSBAE)治疗,进行疗效分析,并观察大咯血患者术后不良反应。结果:17例造影阳性者,成功进行了栓塞,15例即刻止血,2例首次选择性支气管动脉栓塞10 d后复发出血,行超选择栓塞后未再次出血,经0.5～4年的随访,再无复发。8例出现胸痛、低热反应,经对症治疗,反应逐渐减轻至恢复,本组无脊髓、食管损伤等严重并发症。结论:支气管动脉栓塞术治疗大咯血止血迅速、效果确切、并发症少;熟悉疾病的可能供血来源和利用同轴微导管技术是成功的关键。

Objective To evaluate the treatment of bronchial artery embolization for treatment of hemoptysis and its clinical value. Methods using the coaxial microcatheter superselective bronchial artery embolization for 17 cases of patients with massive hemoptysis （ SS- BAE） treatment,to analyze the effects of hemoptysis, and to observe the postoperative side effects. Results 17 cases of patients with posi- tive,conducted successful embolization, 15 cases of immediate hemostasis ,2 cases of the first selective bronchial artery embolization in 10 days after the recurrence of bleeding underwent superselective embolization, no bleeding again, after half a year to four years of follow - up, no recurrence. 8 cases of chest pain,low fever reaction, after symptomatic treatment, reaction reduced gradually to recover, serious complica- tions in the group without spinal cord, esophageal injury. Conclusion Bronchial artery embolization in treatment of massive hemoptysis rapid hemostasis, the exact effect,less complications;may supply sources familiar with the disease and with coaxial microcatheter technique is the key to success.