【摘要】 目的探讨用聚乙烯醇(PVA)、弹簧圈经支气管动脉栓塞(BAE)治疗大咯血的临床疗效。方法对184例内科治疗无效的大咯血患者进行支气管动脉栓塞治疗。其中包括支气管扩张93例,支气管肺癌46例,肺结核33例,支气管动脉一肺动脉瘘8例及支气管病变4例。栓塞材料均选用PVA,部分用PVA+弹簧圈联合栓塞。所有病例随访12个月以上。结果 184例患者均成功进行支气管动脉栓塞,即时止血179例,3例咯血明显减少,2例止血无效,有效率为98.91%(182/184)。术后1个月内咯血复发16例,复发率为8.69%(16/184)。所有患者栓塞后均没有出现严重并发症。结论用PVA、弹簧圈治疗大咯血安全、有效,可作为经内科治疗无效患者的首选治疗方法。更多还原

【Abstract】 Objective To assess the efficacy of bronchial artery embolization(BAE) using PVA particles or microcoil in the management of massive hemoptysis.Methods 184 patients with massive hemoptysis that did not respond to medical management underwent BAE.The causes of hemoptysis included bronchiectasis(n=93) bronchogenic carcinoma (n=46),tuberculosis(n=33),bronchial-pulmonary artery shunt(n=8) and bronchial disease(n=4).Embolization with PVA was performed on all patients.Microcoils were also used on some of the patients.Results BAE was successful on all patients with immediate and complete control of hemoptysis on 179/184 patients,marked reduction on 3 patients,and no effect on 2 patients.Hemoptysis recurred in 16 patients(8.69%) within one month after BAE.There were no serious complications in the 12-month follow-up.Conclusion BAE using PVA particles or microcoil is safe and effective in the management of massive hemoptysis and is the treatment of choice in medically uncontrolled hemoptysis.更多还原