支气管动脉栓塞治疗肺结核大咯血的临床价值

目的:探讨用聚乙烯醇(PVA)或联合弹簧圈经支气管动脉栓塞(BAE)治疗肺结核大咯血的临床价值。方法:对54例内科治疗无效的肺结核大咯血患者行BAE治疗。栓塞材料均选用PVA,部分用PVA+弹簧圈联合栓塞。所有病例随访3～12个月。结果:54例均成功行BAE,即时止血51例,2例咯血明显减少,1例止血无效,有效率为98.1%(53/54)。术后1个月内咯血复发4例,复发率为7.4%(4/54)。所有患者栓塞后均无严重并发症。结论:用PVA或联合弹簧圈治疗肺结核大咯血安全、有效,可作为内科治疗无效患者的首选治疗方法。

Clinical value of bronchial artery embolization in the management of massive hemoptysis due to pulmonary tuberculosis

Objective： To assess the clinical value of bronchial artery embolization（BAE）by using PVA particles or combining coil in the management of massive hemoptysis due to pulmonary tuberculosis.Methods： 54 patients with massive hemoptysis due to pulmonary tuberculosis who had failed to respond to medical management received BAE.Embolization with PVA was performed in all patients,and additional use of coil was carried out in 18 cases.All patients were followed up for 3 to 12 months.Results：BAE was successfully accomplished in 54 patients.Immediate and complete control of hemoptysis was achieved in 51 patients,marked reduce in bleeding was seen in 2 patients,and failure to stop bleeding in 1 patient（98.15%,53/54）.Recurrence of hemoptysis within one month after BAE was seen in 4 patients（7.4%,4/54）.No serious complications occurred.Conclusion：BAE by using PVA particles or coil in the management of massive hemoptysis due to pulmonary tuberculosis is safe and effective,which is the first choice of treatment in patients who had failed to respond to medical management.