不同栓塞剂对支气管扩张与肺结核所致大咯血的疗效比较

发布时间：2018-04-17 04:22

本文选题：咯血 + 支气管扩张　；参考：《实用医学杂志》2017年09期

【摘要】：目的:探讨支气管扩张与肺结核导致的大咯血经明胶海绵颗粒(GSP)/聚乙烯醇颗粒(PVA)栓塞治疗的疗效。方法:回顾性分析271例支气管扩张/肺结核导致的大咯血使用GSP/PVA栓塞患者的临床资料,观察疗效、咯血复发率及并发症的发生率。结果:本研究共纳入271例患者,支气管扩张组176例,肺结核组95例。支气管扩张组术后1周治愈率明显高于肺结核组(73.3%vs 46.3%,P0.05);且支气管扩张组术后1年大咯血复发率明显低于肺结核组(17.6%vs 26.3%,P0.05)。两组患者中,使用GSP的患者术后1周内治愈率均低于使用PVA的患者(支扩组:70.4%vs 77.9%;肺结核组:45.8%vs 47.2%),差异均无统计学意义;而使用GSP的患者1年复发率稍高于使用PVA的患者(支扩组:22.2%vs 10.3%;肺结核组:28.8%vs 22.2%),差异均有统计学意义(P0.05)。所有患者均无严重并发症的发生。结论:支气管扩张导致的大咯血介入动脉栓塞治疗疗效优于肺结核导致的大咯血;使用PVA栓塞的疗效优于GSP;大咯血复发多发生在介入动脉栓塞术后1个月内,且多伴有复杂血供和既往咯血病史。
[Abstract]:Objective: to investigate the effect of embolization of massive hemoptysis caused by bronchiectasis and pulmonary tuberculosis by GSPN / PVA.Methods: the clinical data of 271 patients with massive hemoptysis caused by bronchiectasis and pulmonary tuberculosis with GSP/PVA were analyzed retrospectively to observe the curative effect, recurrence rate of hemoptysis and the incidence of complications.Results: 271 patients were included in this study, 176 in bronchiectasis group and 95 in pulmonary tuberculosis group.The cure rate in bronchiectasis group was significantly higher than that in pulmonary tuberculosis group (73.3 vs 46.3), and the recurrence rate of massive hemoptysis in bronchiectasis group was significantly lower than that in pulmonary tuberculosis group (17.6 vs 26.3%).In both groups, the cure rate of patients with GSP within 1 week was lower than that of patients with PVA (branch dilated group: 70.4 vs 77.9), pulmonary tuberculosis group: 45.8% vs 47.2%, with no significant difference.The one-year recurrence rate of GSP patients was slightly higher than that of PVA patients (branch dilated group: 22. 2 vs 10. 3; pulmonary tuberculosis group: 28. 8 vs 22. 2%). The difference was statistically significant (P 0. 05).No serious complications occurred in all patients.Conclusion: embolization of large hemoptysis caused by bronchiectasis is more effective than that caused by pulmonary tuberculosis, embolization with PVA is better than that with GSP.The recurrence of massive hemoptysis occurs within 1 month after interventional arterial embolization.And often accompanied by complex blood supply and previous history of hemoptysis.
【作者单位】：南京医科大学附属常州第二人民医院呼吸内科;南京医科大学附属常州第二人民医院介入血管科;苏州大学附属三院(常州市第一人民医院)呼吸科;
【分类号】：R521;R562.22

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