【摘要】 目的探讨明胶海绵(GS)颗粒和聚乙烯醇(PVA)颗粒支气管动脉内栓塞治疗急性大咯血的临床疗效。方法48例急性大咯血患者,先行选择性支气管动脉插管造影,然后用导管插管至出血支气管动脉分支,A组(21例)用GS颗粒栓塞,B组(31例)用PVA颗粒栓塞。结果A组21例患者,栓塞后即止血18例(85.7%),72小时止血2例(9.5%),止血有效率95.2%,B组31例患者栓塞后即止血26例(83.9%),72小时止血5例(16.1%),止血有效率100%,A、B两组有效率差异无统计学意义(P>0.05);随访1年,A组复发5例(23.8%),B组复发1例(3.2%),1年复发率差异有统计学意义(P<0.01)。结论支气管动脉栓塞术是治疗大咯血的有效方法,应用PVA颗粒为栓塞剂,安全有效,不易复发,临床疗效显著。更多还原

【Abstract】 Objective To evaluate the effect of bronchial artery embolization(BAE) with gelatin sponge(GS) or polyvinyl alcohol(PVA) in the acute large hemoptysis.Methods Forty-eight patients with acute large hemoptysis were performed selective bronchial arteries angiogaphy,with catheter BAE.The patients in group A(n=21) received GS and group B(n=31) PVA.Results In group A,immediate control of hemoptysis was achieved in eighteen patients((85.7%)),marked reduction in bleeding was seen in two patients((9.5%)),the effective rate for bleeding was(95.2%).In group B,immediate control of hemoptysis was achieved in twenty-six patients((83.9%)),marked reduction in bleeding was seen in five patients((16.1%)),the effective rate for bleeding was 100%,and no significant difference appeared between the two groups(P>(0.05)).All the patients were followed for one year.The recurrence was five patients((23.8%)) in group A and a patient((3.2%)) in group B,with significant difference(P<(0.01)).Conclusion BAE is effective and safe for management of serious hemoptysis,superseletive bronchial PVA is an effective and safe procedure for controlling large hemoptysis.更多还原