急诊介入栓塞术治疗大咯血的临床分析(附54例报告)

曹会存; 赵同源; 李天晓; 刘键; 翟水亭; 史帅涛

doi:10.13201/j.issn.1009-5918.2012.03.008

急诊介入栓塞术治疗大咯血的临床分析(附54例报告)

- 河南省人民医院介入科(郑州, 450003)

详细信息

通讯作者: 李天晓,E-mail:dr.litianxiao@vip.126.com

中图分类号: R44

收稿日期: 2012-02-14

Clinical analysis of emergent embolization in treatment of massive hemoptysis (With 54 cases report)

- Department of Interventional Radiology, Henan provincial people's hospital, Zhengzhou, 450003, China

More Information

Corresponding author: LI Tianxiao, E-mail: dr.litianxiao@vip.126.com

Received Date: 14 February 2012

摘要

摘要: 目的：评价急诊介入栓塞术治疗咯血的有效性、安全性。方法：对54例急诊咯血患者进行动脉造影，明确犯罪血管后应用聚乙烯醇（PVA）颗粒、栓塞微球、明胶海绵颗粒、弹簧圈等材料栓塞出血动脉。结果：造影共发现72条异常动脉，动脉栓塞术成功率98.1%。36例患者术后出血停止，15例患者术后咯血量明显减少，2例患者咯血症状无明显改善，手术有效率94.4%，手术死亡率0。手术并发症：发热、胸痛、胸闷、咳嗽、恶心、呕吐等。结论：急诊介入栓塞术是治疗咯血的安全、有效的方法。
- 急诊 /
- 大咯血 /
- 介入 /
- 栓塞
Abstract: Objective: To evaluate the efficacy and safety of emergent embolization in treatment of massive hemoptysis.Method: 54 patients with emergent hemoptysis were diagnosed by artery angiography, After the abnormal vessels were identified, chose polyvinyl alcohol (PVA) particles, PVA microspheres, gelatin sponge particles, coils or other materials for embolization.Result: 72 abnormal vessels were found in angiography, the success rate of artery embolization was 98.1%. After embolization, 36 patients got immediate and complete hemostasis. Bleeding decreased significantly in 15 patients, but 2 patients' hemoptysis had no significant improvement. The effective rate was 94.4%, the mortality rate is 0. Complications included fever, chest pain, choking sensation in chest, cough, nausea, sickness et al.Conclusion: Artery embolization is an effective and safe therapy in the treatment of emergent hemoptysis.
- emergent /
- massive hemoptysis /
- intervention /
- embolization

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参考文献(13)

[1]	SHIGEMURA N,WAN I Y,YU S C,et al.Multidisciplinary management of life-threatening massive hemoptysis:a 10-year experience[J].Ann Thorac Surg,2009,87(3):849-853.
[2]	DE GREGORIO M A,MEDRANO J,MAINAR A,et al.Endovascular treatment of massive hemoptysis by bronchial artery embolization:short-term and long-term follow-up over a 15-year period[J].Arch Bronconeumol,2006,42:49-56.
[3]	USTUNSOZ B,BOZLAR U,ORS F,et al.Bronchial artery embolization:experience with 10 cases[J].Diagn Interv Radiol,2006,12:43-46.
[4]	樊庆胜,谢春明.隐源性大咯血的DSA表现及栓塞治疗[J].实用医学影像杂志,2003,4(3):160-162.
[5]	CHUN H J,BYUN J Y,YOO S S,et al.Added benefit of thoracic aortography after transarterial embolization in patients with hemoptysis[J].AJR Am J Roentgenol,2003,180:1577-1581.
[6]	HARTMANN I J,REMY-JARDIN M,MENCHINI L,et al.Ectopic origin of bronchial arteries:assessment with multidetector helical CT angiography[J].Eur Radiol,2007,17:1943-1953.
[7]	BALTACIOGLU F,CIMIT N C,BOSTANCI K,et al.Transarterial microcatheter glue embolization of the bronchialartery for life-threatening hemoptysis:technical and clinical results[J].Eur J Radiol,2010,73:380-384.
[8]	GOH P Y T,LIN M,TEO N,et al.Embolization for hemoptysis:A six-year review[J].Cardiovasc Intervent Radiol,2002,25:17-25.
[9]	MICHELLE L W,PETER S,MARK J H.Percutaneous embolotherapy for life-threatening hemoptysis[J].Chest,2002,121:95-102.
[10]	POYANLI A,ACUNAS B,ROZANES I,et al.Endovascular therapy in the management of moderate and massive haemoptysis[J].Br J Radiol,2007,80:331-336.
[11]	KALVA S P.Bronchial artery embolization[J].Tech Vasc Interv Radiol,2009,12:130-138.
[12]	KATO A,KUDO S,MATSUMOTO K,et al.Bronchial artery embolization for hemoptysis due to benign diseases:Immediate and long-term results[J].Cardiovasc Intervent Radiol,2000,23:351-357.
[13]	LEE S,CHAN J W,CHAN S C,et al.Bronchial artery embolisation can be equally safe and effective in the management of chronic recurrent haemoptysis[J].Hong Kong Med J,2008,14:14-20.