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目的分析支气管动脉栓塞术治疗肺咯血的临床价值。方法对87例咯血患者(支气管扩张46例、肺结核18例、肺癌15例、支气管动静脉畸形2例、原因不明咯血6例)行选择性支气管动脉或肋间动脉栓塞治疗。其中支气管动脉栓塞78例,肋间动脉栓塞6例,支气管动脉与肋间动脉一同栓塞3例。2例使用同轴微导管行超选择栓塞,使用明胶海绵微粒栓塞85例,使用明胶海绵微粒与聚乙烯醇颗粒联合栓塞2例。全部病例随访12～18个月。结果栓塞后即刻止血58例,咯血量明显减少19例。于栓塞后1周、2周、1个月分别有5例、3例、2例复发。10例复发患者再次行栓塞治疗后未再出现咯血。有效率为89%(77/87)。全部病例无并发症发生。结论支气管动脉栓塞术是治疗肺咯血的一种安全、有效、微创的有效方法。
Objective To analyze the clinical value of bronchial artery embolization in the treatment of pulmonary hemoptysis. Methods A total of 87 patients with hemoptysis (bronchiectasis 46, tuberculosis 18, lung cancer 15, bronchial arteriovenous malformation 2, unidentified hemoptysis 6) underwent selective bronchial artery or intercostal artery embolization. Among them, 78 cases of bronchial artery embolization, 6 cases of intercostal artery embolization, and 3 cases of bronchial artery and intercostal artery embolization. Two patients underwent superselective embolization with coaxial microcatheter, 85 cases were treated with gelatin sponge particles, and 2 cases were treated with gelatin sponge particles and polyvinyl alcohol granules. All cases were followed up for 12 to 18 months. Results Immediately after embolization in 58 cases of hemostasis, hemoptysis decreased significantly in 19 cases. One week after embolization, two weeks, one month, respectively, there were 5 cases, 3 cases, 2 cases of recurrence. 10 cases of recurrent patients embolization again without hemoptysis. The effective rate was 89% (77/87). No complications occurred in all cases. Conclusion Bronchial artery embolization is a safe, effective and minimally invasive effective method for the treatment of pulmonary hemoptysis.