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目的探讨选择性支气管动脉栓塞治疗大咯血的临床疗效。方法对112例大咯血患者进行选择性造影,寻找到咯血的责任血管,对其用明胶海绵(GS)、聚乙烯醇(PVA)、弹簧圈等材料进行栓塞。随访6～24个月。结果 112例患者,最多栓塞6次,首次动脉栓塞后咯血均停止。术后24h再咯血23例,其中1例再咯血患者经保守治疗无效后行右上肺切除术,15例少量咯血经内科保守治疗后出血停止,其余7例保守治疗无效,再次行介入栓塞治疗。出院后6个月内行二次介入栓塞治疗11例,12个月内行二次介入栓塞治疗6例,18个月内行二次介入栓塞治疗8例,24个月内行二次介入栓塞治疗5例。随访中未发生与栓塞治疗操作相关的严重并发症。结论支气管动脉栓塞术治疗急性咯血具有操作简便、安全可靠,疗效迅速,不良反应、并发症少等优点,可作为抢救患者生命有效治疗手段。
Objective To explore the clinical effect of selective bronchial artery embolization in treating hemoptysis. Methods Selective angiography was performed on 112 patients with massive hemoptysis, finding the responsible vessels for hemoptysis, and embolizing them with gelatin sponge (GS), polyvinyl alcohol (PVA) and coil. Follow-up 6 to 24 months. Results 112 patients, up to 6 times embolization, hemoptysis after the first arterial embolism were stopped. Hemoptysis 23 cases after 24h, of which 1 case of patients with hemoptysis after conservative treatment invalid right upper lung resection, 15 cases of a small amount of hemoptysis after conservative treatment of bleeding stopped, the remaining 7 cases of conservative treatment is invalid, again interventional embolization. Within 6 months after discharge, there were 11 cases of secondary interventional embolization, 6 cases of secondary interventional embolization within 12 months, 8 cases of secondary interventional embolization within 18 months and 5 cases of secondary interventional embolization within 24 months. There were no serious complications associated with embolic treatment at follow-up. Conclusion Bronchial artery embolization for the treatment of acute hemoptysis with simple, safe, reliable, rapid response, adverse reactions, fewer complications, can be used as an effective treatment of patients with life-saving treatment.