Chan V L, So L K Y, Lam J Y M, Lau K-Y, Chan C-S, Lin A W N, Chu C-M
Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong, SAR China.
Int J Tuberc Lung Dis. 2009 Sep;13(9):1167-73.
Tertiary referral centres.
To provide comprehensive updates on the aetiologies, angiographic findings and outcomes of bronchial artery embolisation (BAE) for life-threatening haemoptysis in Hong Kong.
Retrospective review of clinical records of consecutive patients presenting with life-threatening haemoptysis from 2000 to 2006.
There were 3006 admissions due to haemoptysis involving 2260 patients during the study period; of these, 251 patients had life-threatening haemoptysis. Pulmonary tuberculosis (PTB) (active or inactive) and bronchiectasis were the main underlying causes. BAE was attempted in 167 patients. There was a high prevalence of bilateral bronchial arterial abnormalities (31.7%), presence of abnormal non-bronchial arteries (41.3%) and presence of broncho-pulmonary shunt (38.9%). BAE had a high immediate success rate of 95.7%, with a 5-year recurrence rate of 45.0%. Recurrent life-threatening haemoptysis was independently associated with past history of haemoptysis (P = 0.024), presence of broncho-pulmonary shunt (P = 0.013), and incomplete embolisation (P = 0.002). Complications were uncommon (<5%) and self-limiting.
In Hong Kong, about one tenth of admissions due to haemoptysis were life-threatening. PTB and bronchiectasis were the major causes. Complications due to BAE were uncommon and self-limiting, with super-selective catheters.
三级转诊中心。
全面更新香港地区危及生命咯血的支气管动脉栓塞术（BAE）的病因、血管造影结果及治疗效果。
对2000年至2006年期间连续出现危及生命咯血的患者临床记录进行回顾性分析。
研究期间，因咯血入院3006例，涉及2260名患者；其中251例患者出现危及生命的咯血。肺结核（活动期或非活动期）和支气管扩张是主要潜在病因。167例患者尝试进行BAE。双侧支气管动脉异常（31.7%）、存在异常非支气管动脉（41.3%）和存在支气管肺分流（38.9%）的发生率较高。BAE的即刻成功率高达95.7%，5年复发率为45.0%。复发性危及生命咯血与咯血既往史（P = 0.024）、支气管肺分流的存在（P = 0.013）和栓塞不完全（P = 0.002）独立相关。并发症少见（<5%）且为自限性。
在香港，约十分之一的咯血入院患者存在生命危险。肺结核和支气管扩张是主要病因。使用超选择性导管时，BAE引起的并发症少见且为自限性。
