咯血患者支气管动脉栓塞治疗后复发原因分析

目的:探讨咯血患者支气管动脉栓塞(BAE)术后咯血复发的原因及预防措施.方法:632例咯血患者接受支气管动脉栓塞术,进行分阶段疗效追踪,全部病例随访12～14个月,复发病例通过再次手术,确定咯血的复发原因.结果:632例中有114例咯血复发,复发的原因主要有病变血管漏栓(3例)、肺循环供血(2例)、病变血管再通(32例)、侧支循环形成(55例)和原发病进展(54例).采用合理的栓塞技术和栓塞物质组合联合栓塞,寻找所有可能对病变区域供血的血管(支气管动脉、肋间动脉、胸廓内动脉、食管固有动脉、膈动脉等)并予以栓塞,并积极的治疗原发病是预防咯血复发的主要措施.结论:充分认识患者支气管动脉栓塞术后咯血原因对降低复发率有重要的意义.

Causes of Recurrence after Bronchial Artery Embolization for the Treatment of Hemoptysis

Objective:To investigate the causes and precautions of recurrent hemoptysis after bronchial artery embolization (BAE).Methods:Selective or superselective BAE was performed in 632 patients with hemoptysis.All patients were followed up from 12 to 14 months.Patients with recurrent hemoptysis underwent re-embolization after causes for relapse were identified.Results:Causes of recurrent hemoptysis in a total of 114 cases included missed embolization (n=3),pulmonary collateral supply (n=2),recanalization of previously embolized artery (n=32),nonbronchial systemic collateral supply (n=55) and deterioration of the underlying diseases (n=54).Conclusion:Understanding the causes of recurrence in hemoptysis after embolization treatment is helpful for its prevention.