745例介入治疗后大咯血复发的原因和对策分析

To Explore the Causes and Countermeasures for the 745 Patients With Recurrent Hemoptysis After Receiving Interventional Treatment

目的：探讨咯血患者经支气管动脉栓塞介入治疗后出现大咯血复发的原因，并提出降低介入治疗后大咯血复发率的对策。方法收集745例经支气管动脉栓塞介入治疗的患者，对患者进行分阶段的疗效追踪，所有患者均进行12～18个月的随访，复发的患者再次施行手术，并确定患者咯血的复发原因。结果经12～18个月的随访后，咯血复发的病患有235例，复发的原因有原发病进展、侧支循环形成、病变血管再通、肺循环供血、病变血管漏栓。结论明确咯血患者经支气管动脉栓塞介入治疗后出现大咯血复发的原因，积极治疗患者的原发疾病，将可能供血给病变区域的所有血管进行栓塞，采用合理栓塞技术进行栓塞等措施，能有效降低介入治疗后大咯血的复发率。

Objective To investigate the causes of recurrent hemoptysis after interventional treatment by bronchial artery embolism, and to proposed the countermeasures of reducing the recurrence rate of hemoptysis. Methods The data of 745 cases who received the interventional treatment by bronchial artery embolism were collected. We traced the patients by the illness stages. And all of the patients received follow-up visit for 12 to 18 months. The recurrent patients received the operation again and were identiifed the causes of recurrence of hemoptysis. Results After 12 to 18 months, there were 235 patients had recurrent hemoptysis. The reasons for recurrent were primary disease progression, collateral circulation, lesion revascularization, pulmonary insufifciency, and vascular lesions drain plug. Conclusion These measures can reduce the recurrent rate of hemoptysis：understand the reasons of hemoptysis recurrence after intervention treatment by bronchial artery embolization, active treatment for the primary disease, stop the blood supply to all vascular lesions that may be embolism, and choosing reasonable embolization technique..