氰基丙烯酸正丁酯与栓塞微球治疗大咯血对比研究

发布时间：2018-05-13 12:11

本文选题：α-氰基丙烯酸正丁酯 + 栓塞微球　；参考：《介入放射学杂志》2016年12期

【摘要】：目的对比α-氰基丙烯酸正丁酯(NBCA)胶和三丙烯明胶微球(Embosphere)在支气管动脉栓塞术(BAE)治疗肺部大咯血中的安全性和有效性。方法收集2010年1月至2014年12月采用BAE术治疗并有完整随访资料的肺部大咯血患者,其中NBCA胶治疗43例(NBCA组),栓塞微球治疗80例(栓塞微球组),对比两组患者BAE技术成功率和临床止血率、并发症发生率、咯血复发率,并对临床结果进行分析。结果 NBCA组和栓塞微球组BAE技术成功率分别为95.3%(41/43)、96.3%(77/80)(P=0.809);临床止血率分别为93.0%(40/43)、92.5%(73/80)(P=0.639);并发症发生率分别为41.7%(18/43)、35.0%(28/80)(P=0.452),绝大部分为术后胸痛;咯血复发率分别为16.3%(7/43)、28.8%(23/80)(P0.05);两组中各有1例发生脊髓功能障碍,经内科治疗后康复。两组患者Kaplan-Meier生存分析比较结果显示,差异有显著统计学意义(χ~2=6.523,P=0.041)。结论与栓塞微球相比,NBCA胶治疗肺部大咯血的安全性和有效性相当,但能够降低远期复发率。
[Abstract]:Objective to compare the safety and efficacy of 伪 -butyl cyanoacrylate (NBCA) and tripropylene gelatin microspheres (Embospherein) in the treatment of massive pulmonary hemoptysis by bronchial artery embolization (BAE). Methods from January 2010 to December 2014, patients with massive pulmonary hemoptysis who were treated with BAE and had complete follow-up data were collected. Among them, 43 cases were treated with NBCA glue and 80 cases were treated with embolized microspheres. The success rate and clinical hemostatic rate, complication rate, recurrence rate of hemoptysis were compared between the two groups. The clinical results were analyzed. Results the success rate of BAE technique in NBCA group and embolized microsphere group was 95.343 / 46.377 / 80 / 0.809, respectively. The clinical hemostatic rate was 93.040 / 432.5 / 72.5 and 73 / 80 / 80, respectively. The incidence of complications was 41.718 / 43 / 35.028 / 80 / P 0.452a, most of them were postoperative chest pain, and the recurrence rate of hemoptysis was 16.373 / 4343 / 80 / 28.8% P 0.05, respectively. One case of spinal cord dysfunction occurred in each group. Recovered after medical treatment. The results of Kaplan-Meier survival analysis showed that there was significant difference between the two groups (蠂 ~ 2 = 6.523 P 0.041). Conclusion compared with embolized microspheres, NBCA glue is safe and effective in the treatment of massive hemoptysis, but it can reduce the long term recurrence rate.
【作者单位】：杭州师范大学附属医院急诊医学科;杭州师范大学附属医院介入血管科;
【分类号】：R459.7

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