多材料复合栓塞支气管动脉治疗大咯血的临床观察与分析

发布时间：2018-04-02 10:28

本文选题：咯血　切入点：支气管动脉　出处：《临床放射学杂志》2016年06期

【摘要】：目的探讨多种材料复合栓塞支气管动脉治疗大咯血的临床疗效及咯血复发的原因。方法搜集经内科治疗无效的97例大咯血患者的临床资料进行回顾性分析。采用多种栓塞材料,对支气管动脉进行逐级、多方位复合栓塞,术后随访患者2个月~2年,观察栓塞治疗的效果、复发咯血的时间及原因并进行分析与总结。结果97例患者均成功进行了栓塞治疗,其中94例术后咯血即止。随访至2个月时,共10例咯血复发,其中8例属于责任血管漏栓,2例为结核病灶进展致再发咯血。在2个月后的随访中,共8例咯血复发,原因均为原基础病灶进展(6例结核,2例肺癌)。所有患者中未见有因栓塞血管再通而复发咯血者。17例复发者中16例给予2次栓塞治疗后未再发咯血,1例肺结核患者复发2次,行第3次栓塞治疗后咯血停止。结论多材料复合栓塞可减少栓塞血管的再通率,其栓塞彻底、止血效果显著、疗效确切。责任血管漏栓及术后原发病灶进展是其咯血复发的主要原因。
[Abstract]:Objective to investigate the clinical effect of bronchial artery embolization with multiple materials and the causes of hemoptysis recurrence. Methods 97 patients with massive hemoptysis who failed to be treated by internal medicine were collected and analyzed retrospectively. Bronchial artery embolization was carried out step by step and multiple directions. The patients were followed up for 2 months to 2 years. The effect of embolization, the time and cause of recurrent hemoptysis were observed, and the causes of recurrent hemoptysis were analyzed and summarized. Results 97 patients were successfully treated with embolization. Among them, 94 cases of hemoptysis stopped after operation. 10 cases of hemoptysis recurred after follow-up for 2 months, of which 8 cases belonged to the responsible vascular leakage embolus, 2 cases were recurrent hemoptysis caused by the progression of tuberculosis foci. During the follow-up of 2 months, 8 cases of hemoptysis recurred. The causes were 6 cases of pulmonary tuberculosis and 2 cases of lung cancer. Among all the patients, there were no recurrent hemoptysis due to embolization of blood vessels. 16 of 17 patients with recurrent hemoptysis were given 2 times of embolization treatment and 1 case of pulmonary tuberculosis recurred after 2 times of embolization, 1 case of pulmonary tuberculosis did not return to hemoptysis after 2 times of embolization, 1 case of pulmonary tuberculosis recurred 2 times. Conclusion Multi-material composite embolization can reduce the recanalization rate of embolized blood vessels, the embolization is complete, and the hemostatic effect is remarkable. The main cause of recurrent hemoptysis is responsible for vascular leakage and progression of postoperative primary lesion.
【作者单位】：深圳市龙岗中心医院介入放射科;深圳市龙岗中心医院感染科;
【分类号】：R459.7

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