摘要
目的探讨支气管动脉栓塞对治疗大咯血的近期疗效,分析影响再发咯血的危险因素。方法收集2012年1月至2017年3月重庆市职业病防治院呼吸内科收治的因大咯血行支气管动脉栓塞治疗的80例患者的临床资料。术后进行1年的随访,记录患者术后即时止血率,及30 d,90 d,12个月三个时间点的累计咯血控制率及再治疗措施、疗效。以χ2检验、Logistic风险模型分析影响患者短期内再发咯血的危险因素。结果 74例患者在行栓塞治疗后,术后24 h内咯血症状消失,即时有效率为92.5%(74/80)。11例在术后30d内复发咯血,7例患者在术后90d内新发咯血,仅有3例患者在术后12个月内复发咯血,术后30 d、90d、12个月,3个时间点的累计咯血控制率分别为86.25%(69/80)、77.5%(62/80)、73.75%(59/80)。单因素分析结果显示,患者短期内再发咯血与病程长短、是否存在支气管动脉-肺动脉分流相关(P<0.05)。但与患者年龄、性别、疾病的良恶性、病灶数量、栓塞剂类型、术前24 h咯血量无关(P>0.05)。将所有危险因素纳入Logstic回归模型进行多因素分析,结果发现仅有支气管动脉-肺动脉分流是影响患者短期内再发咯血的独立性危险因素。结论支气管动脉栓塞术对大咯血近期疗效确切可靠,术后30 d内咯血最易复发。支气管动脉-肺动脉分流是影响患者短期内再发咯血最主要危险因素。
Objective To investigate the short-term effect of bronchial artery embolization in treatment of massive hemoptysis,and to analyze the risk factors of recurrence. Methods From January 2012 to March 2017,80 patients with massive hemoptysis were treated with bronchial artery embolization in our hospital. They were followed up for 1 year. The immediate hemostasis rate,the control rate of cumulative hemoptysis,the re-treatment measures and the curative effect of 30 d,90 d,and 12 months were recorded. Chi-square test and Logistic risk model were used to analyze the risk factors of recurrent hemoptysis in short term. Results 74 patients received treatment,and the symptoms of hemoptysis disappeared within 24 hours with the Immediate efficiency of 92. 5%（ 74/80）. 11 patients re-occurred with hemoptysis in 30 days,7 patients within 90 days,and 3 patients within 12 months. The cumulative success rate was 86. 25%（ 69/80）,77. 5%（ 62/80） and 73. 75%（ 59/80） respectively at the three time points. Univariate analysis showed that recurrent hemoptysis in short term was related with the duration of the disease and whether there was bronchial artery pulmonary shunt（ P〈0. 05）,but it was not related with age,sex,benign and malignant diseases,the number of lesions,the type of embolic agents or the volume of 24 h before operation（ P〈0. 05）. All the risk factors were included in the Logstic regression model and multivariate analysis,and the results showed that only bronchial artery pulmonary artery shunt was an independent risk factor for recurrent hemoptysis in short term. Conclusion Bronchial artery embolization is effective and reliable in treatment of massive hemoptysis,and the symptoms are most likely to recur within 30 d days after operation. Bronchial artery pulmonary artery shunt is the most important risk factor for recurrent hemoptysis in short term.
作者
陈涵
吴德源
谭远容
CHEN Han;WU De-yuan;TAN Yuan-rong(Department of Respiratory Medicine,Chongqing Occupational Disease Prevention and Control Hospital,Chongqing 400060,China)
出处
《临床肺科杂志》
2018年第7期1314-1317,共4页
Journal of Clinical Pulmonary Medicine
关键词
支气管动脉栓塞
危险因素
咯血
bronchial artery embolizafion
risk factors
hemoptysis
