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目的评价支气管动脉栓塞治疗肺结核大咯血的远期疗效。方法42例均为继发性肺结核,双侧肺结核27例,单侧肺结核15例。采用支气管动脉插管造影,证实为出血动脉后,将PVA微粒或丝线段缓慢注入靶血管内,直至血流停止。结果一次栓塞后34例达到立即止血的目的,7例咯血明显减少,1例无效,近期有效率97.6%,无严重并发症。术后随访6月～7年,24例达临床治愈,显效7例,有效5例,复发6例,远期有效率85.7%。结论支气管动脉栓塞治疗肺结核大咯血是一安全、迅速有效的治疗方法,远期止血效果好,并发症少,结合抗痨治疗有利于巩固疗效。
Objective To evaluate the long-term effect of bronchial artery embolization in the treatment of tuberculosis hemoptysis. Methods 42 cases were secondary to tuberculosis, bilateral tuberculosis in 27 cases, unilateral tuberculosis in 15 cases. Bronchial artery catheterization angiography, confirmed as bleeding arteries, the PVA particles or silk segment slowly into the target vessel, until the blood flow to stop. Results Immediately after embolization, 34 cases achieved the purpose of immediate hemostasis. Seven patients had hemoptysis obviously reduced. One case was ineffective. The effective rate was 97.6%. There was no serious complication. All cases were followed up for 6 months to 7 years. Twenty-four patients were clinically cured, with 7 markedly effective, 5 effective and 6 recurrent. The long-term effective rate was 85.7%. Conclusions Bronchial artery embolization is a safe, rapid and effective treatment for tuberculosis with massive hemoptysis. The long-term hemostatic effect is good with few complications. Combining with anti-tuberculosis therapy is conducive to consolidating the curative effect.