Yu-Tang Goh Peter, Lin Michael, Teo Ngee, En Shen Wong Daniel
Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Republic of Singapore.
Cardiovasc Intervent Radiol. 2002 Jan-Feb;25(1):17-25. doi: 10.1007/s00270-001-0047-1. Epub 2001 Nov 23.
To review our method of embolization for hemoptysis.
Between 1993 and 1999, 134 patients were treated in our department for hemoptysis. One hundred and sixteen patients were followed up (18 were lost to follow-up) over a period ranging from 1 to 66 months (median 9.5 months, SD 14.81 months). Most cases were due to tuberculosis (83.6%) and malignancy (9.5%). One hundred and three required embolization. Vascular access was obtained via the femoral route but two cases required a brachial approach for abnormal branches of the subclavian artery. All abnormal vessels found were embolized using polyvinyl alcohol particles alone or in combination with gelfoam.
Bronchial artery hypertrophy was found in 88.3% of cases; about a third of which had a nonbronchial systemic contribution. No angiographic abnormalities were found in 11.2%. Our failure rate was 18.4% (58% required surgery while 42% died from massive hemoptysis). Sixteen cases required multiple embolization sessions. No major complications were encountered.
Embolization is effective for treatment of moderate to massive hemoptysis. The majority of our cases were due to tuberculosis. Approximately one third had nonbronchial systemic artery contributions, indicating that a concerted search for these is mandatory.
回顾我们对咯血进行栓塞治疗的方法。
1993年至1999年间，我科共治疗134例咯血患者。其中116例患者得到随访（18例失访），随访时间为1至66个月（中位时间9.5个月，标准差14.81个月）。多数病例病因是肺结核（83.6%）和恶性肿瘤（9.5%）。103例需要进行栓塞治疗。血管通路通过股动脉途径建立，但有2例因锁骨下动脉分支异常需要采用肱动脉途径。所有发现的异常血管均单独使用聚乙烯醇颗粒或联合明胶海绵进行栓塞。
88.3%的病例发现支气管动脉增粗；其中约三分之一有非支气管系统供血。11.2%未发现血管造影异常。我们的失败率为18.4%（58%需要手术，42%死于大咯血）。16例需要多次栓塞治疗。未出现严重并发症。
栓塞治疗对中至大量咯血有效。我们的多数病例病因是肺结核。约三分之一有非支气管系统动脉供血，这表明必须对这些血管进行全面探查。
