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目的探讨Embosphere微球联合明胶海绵经导管支气管动脉栓塞(TBAE)治疗支气管扩张大咯血的临床疗效。方法回顾性分析2009年1月至2013年4月东南大学医学院附属江阴医院介入科TBAE术治疗的65例支气管扩张大咯血患者的临床资料,根据所用的不同栓塞材料分成为明胶海绵组(15例)、Embosphere微球组(24例)及二联材料组(明胶海绵+Embosphere微球,26例),对其疗效进行分析。结果 65例患者共栓塞责任动脉120支,随访6~12个月,明胶海绵组7例复发,有效率53.33%(8/15);Embosphere微球组2例复发,有效率91.67%(22/24);二联组2例复发,有效率92.31%(24/26)。Embosphere微球组、二联组总有效率均高于明胶海绵组(P均<0.05),Embosphere微球组与二联组总有效率比较差异无统计学意义(P>0.05)。3组患者并发症主要是胸闷和胸痛,经对症处理后缓解,均无脊髓损伤等严重并发症发生。结论采用Embosphere微球或Embosphere微球联合明胶海绵行TBAE治疗支气管扩张急性大咯血安全、有效。
Objective To investigate the clinical efficacy of Embosphere microspheres combined with gelatin sponge in the treatment of bronchiectasis massive hemoptysis with catheterization of bronchial artery embolism (TBAE). Methods The clinical data of 65 patients with bronchiectasis and hemoptysis treated with TBAE at Jiangyin Hospital Affiliated to Southeast University Medical College from January 2009 to April 2013 were retrospectively analyzed. According to the different embolic materials used, they were divided into gelatin sponge group ), Embosphere microspheres (24 cases) and two groups (gelatin sponge + Embosphere microspheres, 26 cases). The curative effect was analyzed. Results In the 65 patients, there were 120 arterial embolization patients, with a follow - up of 6 to 12 months. In the gelatin sponge group, 7 patients relapsed with an effective rate of 53.33% (8/15). Two patients in the Embosphere microsphere group relapsed with an effective rate of 91.67% 24). Two patients in group 2 relapsed with an effective rate of 92.31% (24/26). The total effective rate in Embosphere microsphere group and the combined group was higher than that in the gelatin sponge group (P <0.05). There was no significant difference in the total effective rate between the Embosphere microsphere group and the double combined group (P> 0.05). Complications in the three groups were mainly chest tightness and chest pain. After symptomatic treatment, no serious complications such as spinal cord injury occurred. Conclusions TBAE using Embosphere microspheres or Embosphere microspheres combined with gelatin sponge is safe and effective in treating bronchiectasis with acute massive hemoptysis.