载药微球治疗原发性肺癌伴咯血疗效及安全性分析

目的比较聚乙烯醇颗粒(PVA)和载药微球治疗原发性肺癌伴咯血的安全性和止血效果。方法回顾性分析2019年10月至2020年10月本院行介入治疗的原发性肺癌伴咯血的患者。主要观察临床栓塞成功率、1个月和6个月内的咯血复发率,术后不良反应,同时观察有无非支气管体循环责任血管以及术后1个月患者部分缓解率。结果共55例患者纳入研究,其中PVA组37例,载药微球组18例。两组临床成功率均为100%。1个月内复发咯血在PVA组和载药微球组中均为1例(P=0.383),6个月内复发咯血分别为5例和1例(P=0.669);非支气管体循环动脉参与供血在PVA组和载药微球组分别为37.8%和38.9%(P=0.91);术后不良反应主要为发热,PVA组和载药微球组分别为3例和9例;术后1个月内的部分缓解率分别为6.7%和37.5%(P=0.026)。结论载药微球作为一种新型栓塞材料治疗原发性肺癌伴咯血安全有效且能缓解肿瘤进展。

Objective To compare the safety and efficacy of polyvinyl alcohol particles and drug-eluting beads bronchial artery chemoembolization in the treatment of lung cancer with haemoptysis.Methods Retrospective analysis and study were conducted on the patients of lung cancer with haemoptysis patients treated at Huzhou Central Hospital from October 2019 to October 2020.The main observations were the success rate of embolization,recurrence of hemoptysis at one month and six months,postoperative adverse effects,as well as the presence of non-bronchial body circulation responsible vessels,and the partial response rates of patients at 1 month after the procedure.Results A total of 55 patients were included in the study according to the inclusion and exclusion criteria,37 in the PVA group and 18 in the DEB-BACE group.The clinical success rate was 100%in both groups.One case of recurrent haemoptysis within one month in the PVA group and one case in the DEB-BACE group(P=0.383),five cases and one case within six months respectively(P=0.669).The participation of non-bronchial body circulation arteries in the blood supply was 37.8%and 38.9%in the PVA and drug-laden microsphere groups respectively,with no statistical difference between the two groups.Non-bronchial body circulation arterial involvement in blood supply was 37.8%and 38.9%in the PVA and DEB-BACE groups respectively(P=0.91).Postoperative adverse effects were mainly fever,three cases in the PVA group and nine cases in the DEB-BACE group.The partial response rates within one month after surgery were 6.7%and 37.5%,respectively,with statistical significance(P=0.026).Conclusion Drug-eluting beads bronchial artery chemoembolization for lung cancer with hemoptysis is safe and effective and reduces tumor progression.