内科保守和支气管动脉栓塞治疗肺癌大咯血的疗效对比研究

Comparative Study of the Efficacy of Conservative Medical and Bronchial Arterial Embolization for Massive Hemoptysis in Lung Cancer

目的对内科保守和支气管动脉栓塞治疗肺癌大咯血的临床效果进行对比研究。方法回顾性分析70例肺癌大咯血患者的临床资料,其中25例患者采用保守治疗方法,45例肺癌大咯血患者采用选择性支气管动脉造影,采用明胶海绵颗粒、聚乙烯醇颗粒或与钢圈联合等方法进行栓塞。所有患者随访2-12个月,对两组患者的疗效及复发率进行评价。结果 45例患者中行左支气管动脉栓塞的有15例,行右支气管动脉栓塞的有17例,行左右支气管动脉栓塞的有13例。支气管内科保守治疗的患者的治愈率为32.0%,18例复发,复发率为72.0%;行支气管动脉栓塞治疗的患者治愈率为82.2%,5例复发,复发率为11.1%;采用明胶海绵颗粒栓塞、聚乙烯醇颗粒、明胶海绵颗粒联合弹簧钢圈双重栓塞、双重栓塞联合弹簧钢圈双重栓塞,术后患者均无严重不良反应发生。结论支气管动脉栓塞治疗肺癌大咯血的临床效果显著,能够降低死亡率和并发症的发生,在临床值得推广应用。

Objective To compare the clinical efficacy of conservative treatment and bronchial arterial embolization for massive hemoptysis in lung cancer. Methods A retrospective analysis of clinical data of 70 cases of lung cancer with massive hemoptysis was conducted. 25 patients received conservative treatment,45 cases was given bronchial arterial embolization with polyvinyl alcohol particles,gelatin sponge particles or in combination with steel coils. All patients were followed up for 2 - 12 months,the curative effects and the recurrence rates of the 2 groups were evaluated. Results Among 45 patients with massive hemoptysis in lung cancer,left bronchial artery embolization was 15 cases,right bronchial artery embolization was 17 cases,left and right bronchial artery embolization was 13 cases. Cure rate of conservative treatment was 32. 0%,18 cases had recurrence,the recurrence rate was 72. 0%; cure rate of bronchial arterial embolization was 82. 2%,5 cases had recurrence,the recurrence rate was11. 1%; gelfoam particles embolization,polyvinyl alcohol particles and gelfoam particles combined spring steel double embolization,double embolization combined spring steel double embolization had no serious adverse reactions. Conclusion Clinical effect of bronchial artery embolization in the treatment of lung cancer with massive hemoptysis is effective,it can reduce mortality and complications,and it is worthy of popularization and application in clinic.