支气管动脉栓塞治疗大咯血35例

目的:探讨支气管动脉栓塞(BAE)治疗大咯血的临床疗效及并发症。方法:对35例大咯血患者经选择性支气管动脉造影后对病变动脉用明胶海绵或PVA颗粒进行栓塞止血,当支气管动脉有脊髓分支或与肋间动脉共干时,用微导管超选择性支气管动脉插管。结果:双侧支气管动脉栓塞11例,左支气管动脉栓塞10例,右支气管动脉栓塞14例,伴肋间动脉2例,有5例次使用同轴导管超选择性支气管动脉病变支插管栓塞。35例患者治愈28例,显效4例,无效3例。总有效率为91.4%,治愈率为80%,未出现严重并发症。结论:支气管动脉栓塞是咯血患者一种安全有效的治疗方法。

Bronchial artery embolization for the treatment of hemoptysis

Objective: To study the clinical effectiveness and complications of bronchial artery embolization for the management of hemoptysis(BAE). Methods: Bronchial artery embolization 35 performed on 35 patients with hemoptysis after the site of bleeding or the abnormal arteries were identified by arteriography.Particles of gelatin sponge and polyvinyl alcohol (PVA) were used separately as embolic agents, super selective bronchial artery, embolization (ss-BAE) was performed with a coaxial microcatheter inserted into the bronchial artery, forming the common trunk with the spinal artery or intercostal artery. Results: A total of 48 arteries (11 common bronchial, 10 left bronchial, 14 right bronchial, 2 intercostal) were embolized, ss-BAE was performed on 5 patients. Of 35 patients, 28 were cured(ie, no active bleeding within 24 hours,no recurrent bleeding during long-term follow-up), 4 were relieved, the success rate was 91.4%, long-term cumulative hemoptysis nonrecurrence rates was 80%, Our failure rate was 8.6%(3/35), no severe complications were observed. Conclusion: Bronchial artery embolization is a safe and effective therapy for massive hemoptysis