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同轴微导管超选择性支气管动脉栓塞治疗咯血的疗效观察

Superselective Bronchial Artery Embolization for Hemoptysis with Coaxial Microcatheter System

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【作者】 刘平康有根曾伟华康仁耀潘伟

【Author】 LIU Ping, KANG You-geng, ZENG Wei-hua,et al.Xiangtan Center Hospital, Xiangtan, Hunan,411100,China$$$$

【机构】 湖南省湘潭市中心医院!湖南湘潭411100

【摘要】 目的 评价同轴微导管超选择支气管动脉栓塞 (SSBAE)治疗咯血的可行性、安全性、疗效 ,并发症。方法  2 9例咯血病人 ,男 2 4例 ,女 5例。年龄 3 5~ 71,平均 54岁。支气管扩张 9例 ,肺结核 12例 ,肺癌 8例。共 3 2例次SSBAE治疗。结果  2 9例病人 ,进行超选择支气管动脉插管 3 3次 ,插管成功率 96 9% ( 3 2 /3 3 ) ,3 2次栓塞成功病人获立即止血效果 :完全控制的 2 1例 ( 65 6% ) ,不完全止血 10例次 ( 3 1 3 % ) ,无效 1例 ( 3 1% )。止血不完全的 10例病人中 ,1例支扩 ,3例慢性纤维空洞性肺结核 ,6例原发性肺癌。随访 2~ 3 2月 ,7例复发出血 ,其中 3例为慢纤空肺结核 ,余 4例为肺癌病人。所有病人均无严重并发症发生。结论 同轴微导管超选择支气管动脉栓塞治疗咯血是一安全 ,止血迅速、疗效确切的治疗措施 ,除肿瘤外 ,远期止血效果好 ,并发症少 ,值得临床推广。

【Abstract】 Objective To evaluate feasibility, effectiveness , safety, and complications of superselective bronchial artery embolization with coaxial microcatheter system for hemoptysis. Methods 32 times of superselective bronchial artery embolization were performed for 29 cases with hemoptysis resulted from a variety of causes, age grade from 35 to 71(mean 54) year old. The causes of hemoptysis included bronchiectasis (9 cases), tuberculosis (12 cases), and pulmonary carcinoma (8 cases). All studies were performed with standard percutaneous transfemoral catheterization. Results The success rate of superselective catheterization was 96 9% (32/33). Hemoptysis control was achieved in 96 9% (31/32), with complete control rate of 65.6% (21/32) and partial control rate of 31.3% (10 /32),inefficacy case:only one.One patient with bronchiectasis, 6 patients with pulmonary carcinoma and 3 patients with chronic fibrosis tuberculosis were included in the partial control group. Rebleeding occurred in 7 patients (4 patients with pulmonary carcinoma and 3 patients with chronic fibrosis tuberculosis) during 2 months to 32 months followed-up period. No severe complications occurred in the procedure. Conclusions Superselective bronchial artery embolization for hemoptysis with coaxial microcatheter is a safe, effective way to control hemoptysis, has excellent long term efficacy, and without severe complications.

【关键词】 咯血支气管,肺栓塞治疗
【Key words】 HemoptysisBronchusLungEmbolizationTreatment
  • 【文献出处】 中国医师杂志 ,Journal of Chinese Physician , 编辑部邮箱 ,2001年07期
  • 【分类号】R560.5
  • 【被引频次】2
  • 【下载频次】23
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