重庆医学2017，Vol.46Issue(30)：4192-4195,4.DOI:10.3969/j.issn.1671-8348.2017.30.006
不同栓塞剂在体-肺循环瘘导致大咯血患者经导管栓塞治疗中的疗效比较
Efficacy comparison of different embolization agents in transcatheter embolization for treating massive hemoptysis caused systemic pulmonary circulation shunt shunt
摘要
Abstract
Objective To evaluate the efficacy difference of different embolization agents in transcatheter embolization for treating massive hemoptysis caused by systemic pulmonary circulation shunt(SPS). Methods The clinical and imaging data in 98 patients with hemoptysis complicating SPS,including bronchodilator in 72 cases,pulmonary tuberculosis in 18 cases and lung carcinoma in 8 cases. All cases were treated with bronchial arterial embolization (BAE). According to different used embolization agents, the cases were divided into the gelfoam group and polyvinyl alcohol(PVA)grains embolization group. All cases were followed up at postoperative 1 d,1,3,6 months as well as 1,2 years. The data were analyzed by using Ridit test. Results Ninety-eight cases of massive hemoptysis were confirmed by DSA,among them,84 cases were complicating pulmonary artery fistula, 18 cases were pulmonary venous fistula and 2 cases were mixed fistula; 32 cases were simple BPS, 62 cases were pulmonary circulation fistula existed in the bronchial arteries and non-bronchial artery and 4 cases were simple non-BPS. The two groups had no complications such as embolism,paraplegia,esophagus-trachea fistula and skin ischemic necrosis. The follow up on postoperative 1 d, at postoperative 1, 3,6 months and at postoperative 1,2 years indicated that among 48 cases in the gelfoam group, 20 cases were cured, 18 cases were significantly effective,6 cases were effective and 4 cases were ineffective,the effective rate was 91.7 % ;among 50 cases in the PVA grain embolization group, 38 cases were cured, 8 cases were significantly effective,4 cases were effective and O case was ineffective, the effective rate was 100%. Moreove no severe complications such as ectopic embolism, paraplegia, esophagus-trachea fistula and skin ischemic necrosis occurred. The difference between the two groups had statistical significance by Ridit analysis. Conclusion Transcatheter embolization for treating massive hemoptysis caused by SPS is safe and reliable,has small trauma, using PVA grains embolization can reduce the long term recurrence rate of hemoptysis.关键词
支气管动脉/咯血/肺循环/栓塞Key words
bronchial arteries/hemoptysis/pulmonary circulation/embolization分类
医药卫生引用本文复制引用
沈松柏,吕维富,华双一,胡四毛..不同栓塞剂在体-肺循环瘘导致大咯血患者经导管栓塞治疗中的疗效比较[J].重庆医学,2017,46(30):4192-4195,4.基金项目
安徽省自然科学基金资助项目(1408085MH162). （1408085MH162）
