支气管动脉栓塞治疗支气管扩张大咯血的技术探讨.pdfVIP

放射学实践 2008 年 6 月第 23 卷第 6 期 Radiol Practice ,jun 2008 ,Vol 23 ,:\10. 6 683 ·介入放射学· 支气管动脉栓塞治疗支气管扩张大咯血的技术探讨 孙松，陆文斌，李忠学，季文斌 【摘要】 目的:探讨支气管动脉栓塞(BAE) 治疗支气管扩张大咯血的疗效。方法:31 例支气管扩张大咯血患者，选择 性支气管动脉造影明确咯血病灶后，对靶血管用明胶海绵颗粒及小条进行栓塞治疗，其中 11 例同时加用弹簧钢圈行多重 栓塞治疗。所有病例门诊随访。结果:31 例患者 BAE 术后 30 例咯血完全停止，即时止血率 96.77 % (30/3 1) 0 3 例在栓 塞术后 1 周内复发大咯血，1 例再次行 BAE 治疗后咯血停止，2 例改行手术治疗，近期复发率 9.68%(3/3 1)。中、远期复 发少量咯血 2 例，复发率为 6.45%(2/3 1)，总有效率 93.55%(29/3 1)。结论:支气管动脉栓塞术治疗支气管扩张大咯血是 一种安全、高效、简便、损伤小的治疗方法，采用多重栓塞可有效降低复发率。 【关键词】 支气管扩张症g 咯血g 支气管动脉;栓塞，治疗性 【中国分类号】 R815; R562.22 【文献标识码】 A [文章编号】 1000-0313(2008)06-0683-03 Treatment of Massive Bronchiectasis Hemoptysis by Bronchial Artery Embolization SUN Song ,LU Wen-bin ,LI Zhong-xue , et a l. Department of Radiology ,the Affiliated Taizhou Hospital of Wenzhou Medicial Collage ,Zhejiang 317000 ,P. R. China [Abstract Objective: To investigate the efficiency of bronchil arterial embolization (BAE) in the treatment of massive bronchiectasis hemoptysis (MBH). Methods: Thirty-one cases of MBH were subjected to selective bronchial arteriography , and all cases were embolized with gelfoam to the target artery , including 11 cases received the combined treatment of gel- foam and spring coils embolization. AII cases were followed up in out-patient c1 inic. Results: MBH was completely controlled in 30 cases immediately affter BAE with the rate of instant hemostasis being 96. 77 %. MBH recurred in 3 cases within one week after BAE with the short-term recurrence rate being 9. 68 % (3/31): one patient had re-embolization and hemoptysis was completely controlled , and 2 were converted to surgical operation. The middle- and long-term recurrence was 9.68% and 6.45% r