支气管动脉栓塞术治疗支气管扩张引起少量咯血的临床价值

The clinical value of bronchial artery embolization for the treatment of minor hemoptysis caused by bronchiectasis

目的:探讨支气管动脉栓塞术治疗支气管扩张引起少量咯血的临床价值。方法:回顾性分析60例支气管扩张引起少量咯血的患者。所有患者胸主动脉CT成像均提示支气管动脉畸形,其中30例患者行支气管动脉栓塞术+药物治疗(介入组),另30例患者仅接受药物治疗(对照组)。对比两组患者治疗后咯血停止时间、2年内咯血复发率以及出现大咯血的比率。结果:介入组30例患者治疗后咯血停止时间为(2. 3±0. 3) d,2年内咯血复发率为23. 3%(7/30),出现大咯血比率为6. 7%(2/30)%;对照组30例患者治疗后咯血停止时间为(4. 5±0. 4) d,2年内咯血复发率为56. 7%(17/30),出现大咯血比率为30. 0%(9/30)。两组比较,差异有统计学意义(P <0. 05)。结论:支气管动脉栓塞术联合药物治疗相比于仅使用药物治疗对支气管扩张引起的少量咯血患者的止血效果更快速有效,同时可以更有效地预防日后咯血复发以及大咯血的发生。

Objective： To investigate the clinical effects of bronchial artery embolization（ BAE） in the treatment of minor hemoptysis induced by bronchiectasis. Methods： Retrospective analysis of data from 60 patients with minor hemoptysis induced by bronchiectasis was done. The bronchial artery abnormalities were suggested by thoracic aorta CT angiography（ CTA）,30 patients were treated by BAE combined with drugs（ intervention group）,and the other 30 patients were treated with drugs only（ control group）. Then after treatment,the stop time of hemoptysis,the recurrence rate of hemoptysis,and the occurrence rate of massive hemoptysis in 2 years were compared between the two groups. Results： Among all 60 cases after treatment,the stop time of hemoptysis,the recurrence rate of hemoptysis,and the occurrence rate of massive hemoptysis in 2 years were（ 2. 3 ± 0. 3） days,23. 3%（ 7/30）,6. 7%（ 2/30） in the intervention group,while those in the control group were（ 4. 5 ± 0. 4）days,56. 7%（ 17/30）,30. 0%（ 9/30）. There were statistically significant differences between the two groups for all these factors（ P〈0. 05）. Conclusion： The BAE combined with drug treatment is faster and more effective than drug treatment only for minor hemoptysis induced by bronchiectasis,and it can also effectively prevent the recurrence of hemoptysis and the occurrence of massive hemoptysis.