非支气管性体动脉在肺结核大咯血介入治疗中的作用

Significance of nonbronchial systemic arteries for interventional therapy in patients with pulmonary tuberculosis

目的探讨非支气管性体动脉(nonbronchial systemic arteries,NBSA)在肺结核大咯血介入治疗中的临床价值。方法对24例行支气管动脉栓塞术(bronchial artery embolization,BAE)的肺结核大咯血患者进行为期2年的随访观察。根据患者是否咯血复发,将24例患者分为未复发组和复发组,比较两组之间的临床资料并进行统计学分析。结果 24例患者经6个月-2年的随访观察,共有11例患者复发咯血。复发组中行主动脉造影者6例(54.5%),明显低于未复发组(92.3%),比较具有统计学意义(P<0.05);复发组中发现有NBSA参与供血的患者10例(90.9%),显著高于未复发组(61.5%,P<0.05);复发组患者供血NBSA平均数(2.87±2.70)与未复发组(1.05±1.12)比较具有统计学意义(P<0.05);复发组完全栓塞例数5例(45.4%)明显低于未复发组(92.3%)(P<0.05)。结论责任NBSA的发现和完全栓塞对于介入治疗肺结核大咯血起着重要作用,可以提高咯血的治疗效果,减少咯血复发率。

Objective TO investigate the clinical value of nonbronchial systemic arteries on interventional therapy in patients with pulmonary tuberculosis.Methods A total of 24 patients with pulmonary tuberculosis and hemoptysis who underwent bronchial artery embolization had been followed up for two years. According to whether the patients have recurrence of hemoptysis, 24 cases were divided into recurrence group and non-recurrence group. Clinical data were statistically analyzed and compared between two groups.Results 24 patients were followed up form 6 months to 2 years,11 patients had recurrence of hemoptysis. In recurrence group aortic angiography was performed in 6 patients （54.5%）, signiifcantly lower than those in no-recurrence group （92.3%）,（P〈0.05）;10 patients were found had NBSA as feeding vessels in recurrence group（90.9%）,signiifcantly higher than those in no-recurrence group（61.5%）. Recurrence group patients also had higher NBSA numbers （2.87±2.70） than no-recurrence group （1.05 ± 1.12） （P〈0.05）; In recurrence group 5 patients had complete embolisation （45.4%）, signiifcantly lower than no-recurrence group（92.3%）（P〈0.05）.Conclusions Discovery of responsible NBSA and complete embolisation plays important role in interventional therapy of pulmonary tuberculosis with hemoptysis, it can improve the therapeutic effect and reduce the recurrence of hemoptysis.