论文部分内容阅读
目的评价大咯血不同血供方式、栓塞方法的疗效及复发因素分析。方法120例大咯血患者行支气管动脉及临近体循环动脉造影,超选择性插管栓塞出血动脉。按供血方式分为单支动脉供血(35例)和多支动脉供血(85例)2组;按栓塞方法分为单纯明胶海绵栓塞(59例)、单纯PVA颗粒栓塞(20例)、PVA颗粒加明胶海绵栓塞(41例)3组,分别行χ2检验,评价各组的疗效。根据治疗效果分为复发(35例)与未复发(85例)为2组,对供血方式和不同栓塞方法进行分析,建立Logistic和Cox回归模型,评价各因素对复发的影响程度。结果120例患者行介入栓塞治疗后咯血均完全停止,技术成功率为100%。随访1～7年,35例复发,总有效率为70.8%。其中单支动脉供血4例复发,复发率11.4%;多支动脉供血31例复发,复发率36.5%。单纯明胶海绵组26例复发,复发率为44.1%;单纯PVA颗粒组3例复发,复发率为15.0%;PVA颗粒加明胶海绵组6例复发,复发率为14.6%。复发率差异有统计学意义(P<0.05)。单纯明胶海绵栓塞后复发时间最短(P<0.05);单纯PVA颗粒栓塞及PVA颗粒加明胶海绵栓塞复发时间较长,但两组之间差异无统计学意义(P>0.05)。结论单纯明胶海绵栓塞和多支动脉供血更容易导致介入栓塞治疗后复发且时间较短;单纯PVA、PVA加明胶海绵栓塞后疗效较好且复发间隔时间较长。
Objective To evaluate the curative effect and relapse factors of different hemoptysis blood supply methods and embolization methods. Methods A total of 120 patients with massive hemoptysis underwent bronchial artery and adjacent systemic arterial angiography, and the cannula was cannulated by superselective catheterization. According to the method of blood supply, the animals were divided into two groups: single artery (35 cases) and multiple branches (85 cases). According to the method of embolization, they were divided into simple sponge embolization (59 cases), simple PVA embolization Add gelatin sponge embolization (41 cases) 3 groups, respectively, χ2 test to evaluate the efficacy of each group. According to the curative effect, the patients were divided into two groups: recurrent (35 cases) and non-recurrent (85 cases). The methods of blood supply and different embolism were analyzed. Logistic and Cox regression models were established to evaluate the influence of each factor on recurrence. Results 120 cases of patients with hemoptysis after interventional embolization were completely stopped, the technical success rate was 100%. Followed up for 1 to 7 years, 35 patients relapsed, the total effective rate was 70.8%. Among them, 4 cases of single artery blood supply recurred, with a recurrence rate of 11.4%; 31 cases of multiple artery blood supply had recurrence with a recurrence rate of 36.5%. The recurrence rate was 44.1% in 26 cases of simple gelatin sponge group and 3 cases of simple PVA granule group. The recurrence rate was 15.0%. The recurrence rate was 14.6% in 6 cases of PVA granule plus gelatin sponge group. The recurrence rate difference was statistically significant (P <0.05). The gelatin sponge embolization time was the shortest (P <0.05); simple PVA embolization and PVA particles plus gelatin sponge embolization longer relapse, but there was no significant difference between the two groups (P> 0.05). Conclusion Simple gelatin sponge embolization and multiple arterial blood supply are more likely to lead to recurrence after embolization and shorter time; simple PVA, PVA and gelatin sponge embolization better curative effect and longer recurrence interval.