摘要
目的:总结大咯血患者的临床特点,并探讨选择性支气管动脉栓塞治疗大咯血的临床疗效。方法回顾性分析40例大咯血患者的临床资料,其中22例患者采用保守治疗方法,18例大咯血患者采用选择性支气管动脉造影,采用聚乙烯醇颗粒或与弹簧圈联合等方法进行栓塞,对比两组患者的疗效。结果在40例大咯血病因中,以支气管扩张例数最多,其次为肺结核、肺曲霉菌病、支气管动脉畸形、肺癌等。内科保守治疗的患者的12例显效(54.5%),4例有效(18.2%),6例无效(27.3%);行支气管动脉栓塞治疗的患者12例术后即刻止血(66.7%),12例治愈(66.7%),6例显效(33.3%);采用聚乙烯醇颗粒或联合弹簧钢圈双重栓塞,术后患者均无严重不良反应发生。结论支气管动脉栓塞治疗肺癌大咯血的临床效果显著,能够降低死亡率的发生,在临床值得推广应用率进行评价。
Objective To conclusion the clinical manifestations of massive hemoptysis and compare the clinical efficacy of conservative treatment and bronchial arterial embolization for massive hemoptysis.Methods A retrospective analysis of clinical data of 40 cases of massive hemoptysis was conducted.22 patients received conservative treatment,18 cases was given bronchial arterial embolization with polyvinyl alcohol particles,or in combination with steel coils.The curative effects of the 2 groups were evaluated.Results Among 40 patients with massive hemoptysis,bronchiectasis was the most common,other causes such as tuberculosis,pulmonary aspergillosis,artery malformation,lung cancer and so on.The remarkable response rate of conservative treatment was54.5%,4 cases were effective,6 cases were noneffective.Cure rate of bronchial arterial embolization was 66.7%,the remarkable response rate was 33.3%,and none of the patients had serious adverse reactions.Conclusion Clinical effect of bronchial artery embolization in the treatment of massive hemoptysis is remarkable,it can reduce mortality,and it is worthy of popularization and application in clinic.
作者
周蜜
ZHOU Mi(Department of Respiratory Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
关键词
大咯血
支气管动脉栓塞
临床疗效
Massive hemoptysis
Bronchial artery embolization
Clinical efficacy
