支气管动脉栓塞术治疗非肿瘤咯血患者的临床分析

Clinical analysis of bronchial artery embolization in the treatment of patients with non-neoplastic hemoptysis

目的探讨支气管动脉栓塞术治疗非肿瘤咯血患者的疗效、影响疗效的因素及并发症。方法回顾性分析2013年1月1日至2014年6月30日在四川大学华西医院因咯血住院行支气管动脉栓塞术治疗的104例非肿瘤患者,总结其疗效、影响疗效的因素及并发症。结果 104例患者的术后立即止血率100%,其中98例患者术后有1年完整随访资料,18例患者复发,临床有效率92.9%,1年咯血控制率81.6%。单因素分析显示肺结核、多支动脉供血、胸膜受累是造成1年内咯血复发影响疗效的危险因素。logistic回归分析显示胸膜受累是1年内咯血复发的独立危险因素。发生并发症的患者共15例(14.4%),其中6例(5.8%)胸痛,4例(3.8%)胸闷,2例(1.9%)恶心,2例(1.9%)低热,1例(1%)穿刺点出血,无严重并发症。结论支气管动脉栓塞术治疗非肿瘤咯血患者疗效好。胸膜受累是1年内咯血复发的独立危险因素。

Objective To explore the efficacy, factors influencing efficacy and complications of bronchial artery embolization （BAE） in the treatment of patients with non-neoplastic hemoptysis. Methods A retrospective study including 104 patients with non- neoplastic hemoptysis undergoing BAE from January 1 st 2013 to June 30 th 2014 was conducted in our hospital. Clinical characteristics were collected. The efficacy, related factor and complications of BAE were analyzed. Results All the patients immediately stopped bleeding after BAE.＇Among the patients ,98 had the whole follow-up data of one year. The recurrent bleeding occurred in 18 patients. The clinical success rate was 92. 9% , and the hemoptysic control rate was 81.6%. Single factor analysis showed that tuberculosis, mul- tiple feeding arteries, and pleural involvement were the risk factors for the recurrent hemoptysis. When these factors were incorporated into multiple factors logistic model, pleura/involvement was an independent risk factor for the recurrent hemoptysis within 1 year. Com- plications occurred in 15 patients （ 14. 4% ） including chest pain （ n = 6,5.8% ）, chest tightness （ n = 4,3.8% ）, nausea （ n = 2, 1.9% ） ,low fever （n = 2,1.9% ） and bleeding of puncture point （n = 1,1% ）. No serious complications were observed. Conclusion BAE is a useful therapy for patients with non-neoplastic hemoptysis. Pleural involvement is an independent risk factor for recurrence of hemoptysis.