不同栓塞剂治疗大咯血的对比研究

目的:观察不同栓塞剂对复发率的影响,探讨并比较不同栓塞剂在支气管动脉栓塞治疗大咯血中的疗效.方法:129例经选择性或超选择性支气管动脉栓塞治疗的大咯血患者,单纯明胶海绵栓塞63例,PVA颗粒联合明胶海绵栓塞组37例,KMG微球联合明胶海绵栓塞组38例.随访16个月,复发病例经再次栓塞.结果:即刻止血率99.2%,复发31例.GS组复发21例,含PvA组复发3例,含KMG组复发5例;1年中总复发率为24.0%;3组复发率差异有显著性意义.结论:合理的选用栓塞物质可有效的降低咯血患者的复发率,PVA颗粒及KMG微球在支气管动脉栓塞治疗大咯血中安全、高效,能有效的减免复发率,值得临床推荐.

Comparison to the Effect of Different Embolic Agents for Treating Massive Hemoptysis

Objective:Comparing the therapy effect and recurrence rate of bronchial artery embolization (BAE) with different embolic agents for treating massive hemoptysis.Methods:129 patients with massive hemoptysis were performed selective BAE or superselective BAE.54 cases used gelatin sponge (GS),37 cases used polyvinyl alcohol (PVA),and 38 cases used KMG as embolic agents.All patients were followed up 16 months,and the second embolization was performed immediately if relapse happened.Results:128 patients (99.2%) were successful embolization,and 131 of them had recurrent hemoptysis,including 23 cases embolized with GS,3 with PVA,5 with KMG.There exist significant difference in the recurrence of three groups.Conclusion:Resonable choice of embolic agents are important in reducing recurrence.As embolic agents to treat massive hemoptysis,the effect of PVA and KMG are better than that of GS.PVA and KMG are the best of choice in clinical to treat massive hemoptysis with BAE.