经支气管动脉介入治疗儿童咯血的临床疗效研究

Clinical Study of Bronchial Artery Intervention in the Treatment of Hemoptysis in Children

目的探讨经支气管动脉介入对于儿童咯血治疗的临床效果。方法选择2016年8月-2017年8月新乡医学院收治的经内科保守治疗咯血未得到有效控制的38例咯血儿童作为研究对象,使用数字血管造影对患儿行支气管动脉和肺动脉造影,通过支气管动脉灌注和栓塞手术,并根据患儿咯血情况予以止血剂混合明胶海绵颗粒栓塞剂和弹簧栓,术后给予患儿一年随访。结果经过治疗后,所有咯血儿童均手术成功,31例患儿经支气管动脉介入治疗即刻止血,即刻止血率为81.6%;4例患儿3~5天后得到止血,治疗有效率为92.1%。此外,3例咯血复发患儿经二次栓塞治疗后得到止血。有1例患儿出现不良反应。结论与内科保守治疗咯血相比,针对儿童咯血临床应用经支气管动脉介入治疗,可以有效地起到咯血止血的效果,对于患儿的不良反应影响较小,值得临床应用。

Objective To investigate the clinical effect of bronchial artery intervention on hemoptysis in children.Methods From August 2016 to August 2017,38 children with hemoptysis were selected as the subjects.The bronchial artery and pulmonary artery were examined by digital angiography.The bronchial artery was perfused and embolized.According to the hemoptysis,the children were treated with gelfoam granule embolization and spring embolization.Children were followed up for one year.Results All the children with hemoptysis were operated successfully after treatment.The immediate hemostasis rate was 81.6%in 31 cases and 92.1%in 4 cases after 3-5 days.In addition,3 children with recurrent hemoptysis received hemostasis after two embolization treatments.There were 1 cases of adverse reactions.Conclusion Transbronchial arterial interventional therapy can effectively stop hemoptysis in children with hemoptysis,and has little adverse effect on children.It is worth popularizing and applying in clinic.