摘要
目的:观察经导管动脉栓塞术(TAE)治疗大咯血的近期及远期疗效,分析影响大咯血远期疗效的因素。方法:回顾性分析本院采用TAE治疗大咯血的52例患者的病例资料,包括栓塞前后血管造影表现、咯血的责任血管、复发咯血时间、并发症。采用Kaplan-Meier方法计算TAE术后咯血的控制率。结果:大咯血的病因包括肺内肿瘤16例、肺结核14例、支气管扩张11例、肺结核合并支气管扩张8例、肺内血管畸形1例、不能明确病因2例。52例患者总共栓塞了72支支气管动脉及13支非支气管动脉,止血成功率90%(47/52)。随访1～57个月,平均29个月,共有14例(30%)复发咯血。复发率最高组为肺结核合并支气管扩张组有4例复发,复发率50%(4/8);肺结核组5例复发,复发率36%(5/14);支气管扩张组2例复发咯血,复发率18%(2/11);复发率最低组为肺内肿瘤组(12.5%,2/16)。Kaplan-Meier方法分析本组患者术后1个月、12个月、48个月咯血控制率分别为85%、70%、68%。结论:血管内栓塞法对大咯血患者是一种安全有效的治疗方法,术后积极治疗原发病及预防控制感染是提高远期疗效的有效手段。
Objective：To review the short-term and long-term results in patients with life-threatening hemoptysis treated by transcatheter arterial embolization（TAE）,and to analyze the factors of long-term outcome.Methods：The clinical materials of 52 patients having life-threatening hemoptysis and treated with TAE were analyzed retrospectively,including the angiographic manifestations before and after TAE,the responsible bleeding arteries,time of recurrence and complications.Kaplan-Meier curves were used to analyze the rate of hemotysis controlled.Results：The major causes of hemoptysis included lung tumor（16 cases）,tuberculosis（14 cases）,bronchiectasis（11 cases）,bronchiectasis accompanied with tuberculosis（8 cases）,vascular anomaly（1 cases） and unknown cause（2 cases）.Totally 72 bronchial arteries and 13 non-bronchial arteries were embolized.The rate of success was 90%（47/52 cases）.All patients were followed up over a period ranging from 1 month to 57 months（mean 29 months）,and 14 cases had hemoptysis recurrence.The highest recurrent rate was assessed in the group of tuberculosis accompanied with bronchiectasis（4/8 cases,50%）.Recurrent hemoptysis in the group of tuberculosis was seen in 5 cases（5/14,36%）,in the group of bronchiectasis was 18%（2/11 cases）.The lowest recurrent rate was seen in the group of lung tumor（2/16 cases,12.5%）.The rate of hemoptysis controlled calculated with Kaplan-Meier curve at 1,12 and 48 months was 85%,70% and 68% respectively.Conclusion：TAE is an effective and safe approach for the treatment of life-threatening hemoptysis.Treating the primary disease and preventing pulmonary infection can effectively improve the therapeutic effect.
出处
《放射学实践》
2012年第10期1124-1127,共4页
Radiologic Practice
关键词
咯血
栓塞
治疗性
治疗结果
Hemoptysis
Embolism
therapeutic
Treatment outcome
