Koblízek V, Chovanec V, Krajina A, Salajka F, Lojik M, Raupach J, Skricková J, Chlumský J
Plicní klinika Lékarské fakulty UK a FN Hradec Králové.
Vnitr Lek. 2006 Dec;52(12):1162-71.
Moderate and severe hemoptysis is a potential life-threatening condition which requires immediate medical examination and intervention.
Retrospective evaluation of the effectiveness of bronchial artery embolization in the management of hemoptysis (over 50 ml per 24 hours) in the university hospital (from 1998 to 2005).
A retrospective case study. Forty seven consecutive patients with hemoptysis over 50 ml per 24 hours were reviewed and data collected from medical documentation (medical history, chest X-ray, bronchoscopy, thorax spiral CT, pulmonary and bronchial angiography).
Forty seven patients, 34 men and 13 women aged between 19-87 years, mean age of 57.1 years, were included in this study. All patients had clinically important hemoptysis (more than 50 ml blood in 24 hours), 23 patients 50-200 ml, 14 patients 200-500 ml, 10 patients over 500 ml. Twenty eight patients had reccurent hemoptysis and nineteen patients had the first stage of hemoptysis. Within the study group we recorded the following clinical causes of hemoptysis: 12 COPD with bronchiectasis, 11 pulmonary malignancy, 11 idiopatic hemoptysis, 5 arterioarterial shunts, 3 pneumonia, 2 aspergillomas, 1 posttuberculous scars, 1 pulmonary trauma, 1 pulmonary arteriovenous malformation. All 47 patients underwent angiography. Thirty seven bronchial artery embolizations (BAE) were performed on the side with greater bronchoscopy and CT abnormality. Polyvinyl-alcohol (sponge particles 45-350 pm) or acrylate glue were used as embolizing agents. We did not observe any complication during this procedures (BAE). Immediate success i.e. cessation of hemoptysis was achieved in 36 patients (97%). Follow-up lasted 4-63 months (33 patients). BAE resulted in long-term success i.e. no recurrent hemoptysis for 28 patients (85%).
Transcatheter bronchial artery embolization is an effective and safe procedure for patients suffering from clinically important hemoptysis. Short-term control of hemoptysis can be achieved in 97% and long-term control in 85% of cases. Bronchial artery embolization is a treatment which can reduce the need for acute thoracic surgery.
中度和重度咯血是一种潜在的危及生命的状况，需要立即进行医学检查和干预。
回顾性评估大学医院（1998年至2005年）中支气管动脉栓塞术治疗咯血（每24小时超过50毫升）的有效性。
一项回顾性病例研究。对连续47例每24小时咯血超过50毫升的患者进行了回顾，并从医疗记录（病史、胸部X光、支气管镜检查、胸部螺旋CT、肺和支气管血管造影）中收集数据。
本研究纳入了47例患者，其中男性34例，女性13例，年龄在19 - 87岁之间，平均年龄57.1岁。所有患者均有临床上重要的咯血（24小时内咯血超过50毫升），23例患者咯血量为50 - 200毫升，14例患者为200 - 500毫升，10例患者超过500毫升以上。28例患者有反复咯血，19例患者为首次咯血。在研究组中，我们记录了以下咯血的临床病因：12例慢性阻塞性肺疾病合并支气管扩张，11例肺恶性肿瘤，11例特发性咯血，5例动动脉分流术，3例肺炎患者，2例曲霉菌瘤，1例肺结核后瘢痕，1例肺外伤，1例肺动静脉畸形。所有47例患者均接受了血管造影。在支气管镜检查和CT异常较严重的一侧进行了37次支气管动脉栓塞术（BAE）。使用聚乙烯醇（45 - 350微米的海绵颗粒）或丙烯酸酯胶作为栓塞剂。在这些操作（BAE）过程中，我们未观察到任何并发症。36例患者（97%）立即取得成功，即咯血停止。随访持续4 - 63个月（33例患者）。BAE导致28例患者（85%）获得长期成功，即无咯血复发。
经导管支气管动脉栓塞术对于患有临床上重要咯血的患者是一种有效且安全的手术。97%的病例可实现咯血的短期控制，85%的病例可实现长期控制。支气管动脉栓塞术是一种可以减少急性胸外科手术需求的治疗方法。
