支气管动脉栓塞术治疗支气管扩张所致咯血41例

Clinical effect of bronchial arterial embolization in the treatment of patients with bronchiectagis and hemoptysis

目的探讨支气管动脉栓塞术治疗支气管扩张所致咯血的临床应用价值。方法 41例支气管扩张所致咯血的患者进行选择性支气管动脉栓塞术,术后随访12个月,观察疗效,行统计分析。结果立即止血40例,止血率97.5%,12个月内复发11例,复发率26.8%,其中术中应用弹簧钢圈≥3枚复发率明显高于应用弹簧钢圈≤2枚的患者,差异有统计学意义,P<0.05。结论变范围局限的支气管扩张咯血患者应用选择性支气管动脉造影近期及远期效果好,复发率低;支气管扩张病变广泛的咯血患者应用选择性支气管动脉栓塞术治疗近期止血效果好,但远期复发率高,故建议对胸部CT提示病变广泛的咯血患者内科治疗效果差者,如有外科手术指征者,考虑手术治疗。

Objective To investigate the clinical value of bronchiectagis with hemoptysis patients treated by bronchial arterial embolization.Methods Choosing 41 patients with bronchiectagis and hemoptysis treated by bronchia larterial embolization, postoperative follow-up of 12 months to observe curative effect and do statistic analysis.Results Immediately stop bleeding in 40 cases, hemostasis rate was 97.5%, but the recurrence rate was 26.8% within 12 months; recurrence rate was statistically significant differences that the patients who intraoperative application of spring steel≥3 pieces was higher than application spring steel≤2 pieces（P＆lt;0.05） Conclusion Bronchiectasis patients with lesions of extensive scope treated by selective bronchial arteriography and embolization have a higher recurrence rate, so suggest that patients with lesions of extensive scope should go to surgery if have surgical testify.