海藻酸钠微球支气管动脉栓塞材料治疗肺结核大咯血的有效性

Therapeutic effectiveness of sodium alginate microspheres as bronchial artery embolization material on pulmonary tuberculosis hemoptysis

背景:临床对肺结核大咯血患者实施支气管动脉栓塞介入治疗过程中,可以选择不同的栓塞材料,其中海藻酸钠微球和明胶海绵是两种常用的材料,但目前关于两种材料应用效果的比较分析相关报道相对较少。目的:分析海藻酸钠微球支气管动脉栓塞治疗肺结核大咯血的临床有效性。方法:纳入157例肺结核大咯血患者,其中男98例,女59例,年龄22-75岁,均实施支气管动脉栓塞治疗,按照栓塞材料的不同分为海藻酸钠微球组(n=74)和明胶海绵组(n=83)。栓塞治疗后随访12个月,观察两组临床疗效、复发情况及并发症发生情况。结果与结论:经疗效判定,海藻酸钠微球组和明胶海绵组的治疗总有效率分别为91.2%和81.9%,组间治疗总有效率比较差异有显著性意义(P<0.05);海藻酸钠微球组和明胶海绵组的复发率分别为6.8%和26.5%,组间复发率比较差异有显著性意义(P<0.05);两组并发症发生情况比较差异无显著性意义(P>0.05)。表明海藻酸钠微球支气管动脉栓塞治疗肺结核大咯血临床有效率高、复发率低,效果更理想。

BACKGROUND： Different embolic materials can be used for bronchial artery embolization in patients with pulmonary tuberculosis hemoptysis. Sodium alginate microspheres and gelatin sponge are two commonly used materials; however, there are relatively few related reports about the comparative analysis on the application effect of these two materials. OBJECTIVE： To investigate the clinical efficacy of sodium alginate microspheres for bronchial artery embolization on pulmonary tuberculosis hemoptysis. METHODS： Totally 157 patients with pulmonary tuberculosis hemoptysis, including 98 male and 59 female patients, aged 22-75 years, were enrolled and subjected to bronchial artery embolization using different embolic materials： sodium alginate microspheres group （n=74） and gelatin sponge group （n=83）. During the 12 months of follow-up, the clinical curative effect, recurrence and complications condition of these two groups were observed. RESULTS AND CONCLUSION： The total effective rates of sodium alginate microspheres and gelatin sponge groups were respectively 91.19% and 81.93%, and there was a significant difference between groups （P 〈 0.05）. The recurrence rates of sodium alginate microspheres and gelatin sponge groups were respectively 6.8% and 26.5%, and there was a significant difference between groups （P 〈 0.05）. Additionally, there was no significant difference in the complications between groups （P 〉 0.05）. These results demonstrate that sodium alginate microspheres for bronchial artery embolization has a better result in the clinical treatment of pulmonary tuberculosis hemoptysis with a high clinically effective rate and low recurrence rate.