肺癌伴大咯血的急诊栓塞治疗

Embolotherapy for the management of lung cancer with massive hemoptysis

目的 探讨支气管动脉栓塞治疗肺癌伴大咯血的适应症、并发症及疗效等。方法 回顾性分析1996年 1月至 2 0 0 3年 1月我院收治的肺癌伴大咯血患者 3 8例。 3 8例患者均表现为急性大咯血 ,2 4h咯血量为 2 2 0～ 980ml ,平均 2 90ml。以Seldinger技术穿刺右股动脉插管 ,再行患侧支气管动脉选择性插管造影 ,并栓塞出血血管。结果 栓塞后 ,所有病例咯血量明显减少 ,2 4h咯血量 <60ml ,并在 3～ 4天内停止咯血。1例患者栓塞后 2月症状复发 ,予再次栓塞后未再咯血。全组无严重并发症发生。结论 支气管动脉栓塞治疗肺癌伴大咯血安全。

Objective To investigate the indication, complication and efficacy of bronchial artery embolization for the management of lung cancer with massive hemoptysis. Methods Thirty eight cases of lung cancer with massive hemoptysis were retrospectively analyzed in our hospital from January 1996 to January 2003. All cases presented with acute hemoptysis from 220 to 980 ml daily, with a mean of 290 ml daily. A digital subtracted bronchial arteriogram was perfomed and bleeding arteries were embolized. Results Hemoptysis decreased gradually in all cases and ceased in 3 or 4 days after embolization. Recurrence was found only in one case 2 months after embolization and second embolization was applied to control hemoptysis. No serious complications occured. Conclusion Bronchial artery embolization is safe and efficient for the management of lung cancer with massive hemoptysis.