支气管动脉栓塞术后再发咯血的危险因素分析

Risk factors analysis on rebleeding after bronchial artery embolization

目的探讨咯血患者行支气管动脉栓塞术(BAE)后复发咯血的相关风险因素及其相关性。方法收集因咯血行BAE治疗患者75例,按照是否再次发生咯血进行分组,对比两组患者间在年龄、性别、原发病因、病程、咯血量、栓塞剂、血管造影表现等因素的影响,并评价其相关性。结果 17.33%(13/75)的患者在BAE后复发咯血,在有无咯血两组患者中,支气管动脉-肺动/静脉分流的构成差异具有统计学意义,两组年龄、性别、原发病因、病程、咯血量、栓塞剂因素差别均无统计学意义。多变量回归分析提示,支气管动脉-肺动/静脉分流与术后复发咯血有明显的相关性。结论支气管动脉-肺动/静脉分流的存在是导致BAE后复发咯血的显著风险因素。

Objective To investigate the risk factors and correlation of rebleeding after bronchial artery embolization（BAE） in patients with hemoptysis. Methods Seventy-five patients with hemoptysis who were treated with BAE were divided into two groups based on with or without rebleeding after BAE. Comparison and correlation on the influence of different factors such as age, gender, protopathy, pathogenesis, amount of bleeding, emboliaztion agents, angiography and so on were analyzed in detail. Results Rebleeding after BAE were diagnosed in 17.33%（13/75） cases. During all the factors, only the bronchial-pulmonary artery/vein shunt between the two groups showed significant difference. Other factors such as age, gender, protopathy, pathogenesis, amount of bleeding, emboliaztion agents have no difference. Multivariate regression analysis justified esophageal fistula was strongly related to post operative hemorrhage. Conclusions Bronchial-pulmonary artery/vein shunt is the main risk factor of rebleeding after BAE.