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支气管动脉栓塞术治疗年轻囊性纤维化患者咯血

Bronchial artery embolization for hemoptysis in young patients with cystic fibrosis.

作者信息

Barben Juerg, Robertson David, Olinsky Anthony, Ditchfield Michael

机构信息

Department of Respiratory Medicine, Royal Children's Hospital, Flemington Rd, Parkville 3052, Victoria, Australia.

出版信息

Radiology. 2002 Jul;224(1):124-30. doi: 10.1148/radiol.2241010654.

Abstract

PURPOSE

To review the authors' 15-year experience with bronchial artery embolization (BAE) for treatment of hemoptysis in young patients with cystic fibrosis.

MATERIALS AND METHODS

By searching the 1985-1999 radiology database, the authors identified 23 young patients who had been referred to the radiology department for angiography. Twenty of these patients underwent BAE. The 23 medical records were retrospectively reviewed with regard to embolization agents used, embolization success rates, number of repeat embolizations, survival times, and causes of death.

RESULTS

BAE was performed on 38 occasions in 20 patients. The mean age of patients at first BAE was 15 years (age range, 7-19 years). The majority (n = 34 [89%]) of BAEs were performed by using polyvinyl alcohol. The immediate success rate after BAE (ie, no recurrent bleeding within 24 hours) was 95% (36 of 38 BAEs). Eleven (55%) patients required more than one BAE, and the median time between first and second embolizations was 4 months (range, 5 days to 61 months). Three patients died as a consequence of severe hemoptysis during induction of anesthesia with intermittent positive pressure ventilation in preparation for BAE. The median survival duration after the first BAE (Kaplan-Meier estimate) was 84 months (average follow-up, 61 months; range, 5 days to 169 months).

CONCLUSION

BAE had a high success rate for short-term control of bleeding; however, more than half the patients required repeat embolization during the long-term follow-up.

摘要

目的

回顾作者15年来使用支气管动脉栓塞术(BAE)治疗囊性纤维化年轻患者咯血的经验。

材料与方法

通过检索1985 - 1999年的放射学数据库,作者确定了23名转诊至放射科进行血管造影的年轻患者。其中20名患者接受了BAE。对这23份病历进行回顾性分析,内容包括所用栓塞剂、栓塞成功率、重复栓塞次数、生存时间及死亡原因。

结果

20例患者共进行了38次BAE。首次BAE时患者的平均年龄为15岁(年龄范围7 - 19岁)。大多数(n = 34 [89%])BAE使用聚乙烯醇进行。BAE后的即刻成功率(即24小时内无再次出血)为95%(38次BAE中的36次)。11例(55%)患者需要不止一次BAE,首次与第二次栓塞之间的中位时间为4个月(范围5天至61个月)。3例患者在准备BAE时因间歇正压通气诱导麻醉期间严重咯血死亡。首次BAE后的中位生存时间(Kaplan - Meier估计)为84个月(平均随访61个月;范围5天至169个月)。

结论

BAE在短期控制出血方面成功率较高;然而,超过一半的患者在长期随访期间需要重复栓塞。

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