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经支气管动脉微导管胶栓塞术治疗危及生命的咯血:技术和临床结果。

Transarterial microcatheter glue embolization of the bronchial artery for life-threatening hemoptysis: technical and clinical results.

机构信息

Marmara University School of Medicine, Department of Radiology, Istanbul, Turkey.

出版信息

Eur J Radiol. 2010 Feb;73(2):380-4. doi: 10.1016/j.ejrad.2008.10.017. Epub 2008 Dec 13.

Abstract

OBJECTIVES

To report our experience with transarterial glue embolization of the bronchial artery for life-threatening hemoptysis.

MATERIALS AND METHODS

Twenty-five patients underwent bronchial artery embolization, using coaxial microcatheter technique, with a liquid agent, n-butyl-2-cyanoacrylate (NBCA), named glue, for life-threatening hemoptysis. The technical and clinical outcomes were followed in terms of immediate control of bleeding, recurrence of hemoptysis and complications of the procedure.

RESULTS

Four patients had acute hemoptysis when they were evaluated. The average number of arteries embolized per patient was 2.9. BAEs were successful in controlling hemoptysis immediately in all 25 patients (100%) and in 24 patients (96%) at 1 month follow-ups. One patient had recurrent hemoptysis on the tenth day after embolization. The follow-up time ranged from 2 to 63 months (mean 14 months). Six patients (25%) died all as a result of their disease process. Bleeding recurred in 3 patients after 30 days (7th, 11th, 12th months). One patient had vomitting attacks with dysphagia after the procedure that lasted 24h. Three patients had transient thoracic pain lasting 3-5 days. There were no procedure related spinal or vascular complications.

CONCLUSIONS

Glue embolization with microcatheter technique is a safe and effective treatment in cases of life-threatening hemoptysis with a very high rate of success and low rate of complications.

摘要

目的

报告我们采用经动脉胶栓塞支气管动脉治疗危及生命的大咯血的经验。

材料与方法

25 例患者因危及生命的大咯血而行支气管动脉栓塞术,采用同轴微导管技术,使用液态制剂 n-丁基-2-氰基丙烯酸酯(NBCA)即胶进行栓塞。根据即时止血效果、大咯血复发情况和手术并发症评估技术和临床结果。

结果

4 例患者在评估时出现急性大咯血。每位患者平均栓塞的动脉数为 2.9 条。25 例患者均立即成功控制咯血(100%),24 例(96%)在 1 个月随访时成功控制咯血。1 例患者在栓塞后第 10 天再次出现大咯血。随访时间为 2 至 63 个月(平均 14 个月)。6 例患者(25%)全部因疾病进程而死亡。3 例患者在 30 天后(第 7、11、12 个月)复发大咯血。1 例患者在术后出现持续 24 小时的呕吐和吞咽困难。3 例患者出现短暂的胸痛,持续 3-5 天。无手术相关的脊髓或血管并发症。

结论

采用微导管技术的胶栓塞术是治疗危及生命的大咯血的一种安全有效的方法,成功率高,并发症发生率低。

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