Lee Samuel, Chan Johnny W M, Chan Susan C H, Chan Y H, Kwan T L, Chan M K, Ng C K, Lee M P, Law W L, Mok Thomas Y W
Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
Hong Kong Med J. 2008 Feb;14(1):14-20.
To examine the efficacy and safety of bronchial artery embolisation in patients with acute major haemoptysis and those with chronic recurrent haemoptysis.
Retrospective review of clinical records.
Regional hospital, Hong Kong.
Clinical records of 70 consecutive patients who had undergone bronchial artery embolisation in Queen Elizabeth Hospital from 1998 to 2003 were reviewed. Altogether 74 bronchial artery embolisation procedures were attempted, 46 (62%) for acute major haemoptysis, and 28 (38%) for chronic recurrent bleeding. Follow-up data were available for 32 patients.
After bronchial artery embolisation, the Kaplan-Meier method and log-rank tests were used to compare the probability of recurrence in the two patient categories.
Overall immediate control was attained following 99% of the procedures, with a complication rate of 13%; all complications were mild and self-limiting. For the 32 patients (19 having acute major haemoptysis and 13 having chronic recurrent bleeding) with follow-up data available, the overall recurrence rate was 36% (26% in the acute and 47% in chronic group). No statistically significant difference in recurrence probability between the two groups was observed (P=0.24). Presence of active pulmonary tuberculosis was associated with increased risk of recurrence (P=0.005).
Bronchial artery embolisation was noted to be effective and safe in both acute major and chronic recurrent haemoptysis.
探讨支气管动脉栓塞术对急性大量咯血患者和慢性复发性咯血患者的疗效及安全性。
临床记录回顾性研究。
香港地区医院。
回顾性分析1998年至2003年在伊丽莎白医院连续接受支气管动脉栓塞术的70例患者的临床记录。共尝试了74例支气管动脉栓塞术，其中46例（62%）用于急性大量咯血，28例（38%）用于慢性复发性出血。32例患者有随访数据。
支气管动脉栓塞术后，采用Kaplan-Meier法和对数秩检验比较两组患者咯血复发的概率。
99%的手术实现了即时止血控制，并发症发生率为13%；所有并发症均为轻度且可自愈。对32例有随访数据的患者（19例急性大量咯血，13例慢性复发性出血）进行分析，总体复发率为36%（急性组为26%，慢性组为47%）。两组之间的复发概率无统计学显著差异（P=0.24）。活动性肺结核的存在与复发风险增加相关（P=0.005）。
支气管动脉栓塞术对急性大量咯血和慢性复发性咯血均有效且安全。
