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[支气管及非支气管体动脉栓塞术治疗咯血:31年经验]

[Bronchial and nonbronchial systemic artery embolization in managing haemoptysis: 31 years of experience].

作者信息

Cornalba G P, Vella A, Barbosa F, Greco G, Michelozzi C, Sacrini A, Melchiorre F

机构信息

Dipartimento di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano, Ospedale San Paolo, Via di Rudini 8, 20142, Milano, Italy.

出版信息

Radiol Med. 2013 Oct;118(7):1171-83. doi: 10.1007/s11547-012-0866-y. Epub 2012 Aug 9.

Abstract

PURPOSE

The authors report on 31 years of experience with bronchial (BAE) and/or nonbronchial (NBAE) systemic artery embolisation for managing haemoptysis.

MATERIALS AND METHODS

A total of 534 patients who underwent bronchial artery angiography for haemoptysis between 1979 and 2010 were retrospectively evaluated. Of these patients, 477 (89%) had active bleeding and underwent BAE and/or NBAE (295 males and 182 females, aged between 12 and 71 years). Embolisation techniques, materials, major and minor complications and relapses were recorded.

RESULTS

Complete resolution of haemoptysis was achieved within 24 h in 458/477 (96%) cases and within 48 h in 2% of cases. The aetiology of haemoptysis was as follows: cystic fibrosis (23%), bronchiectasis (13%), tuberculosis sequelae (8%), chronic obstructive pulmonary disease (COPD) (6%) and no apparent cause (21%). Major complications were recorded in 3/477 (0.6%): stroke (n=1), transient ischaemic attack (TIA) (n=1) and transient quadriplegia (n=1). Minor complications were recorded in 143/477 (30%): chest pain 86/143 (60%) and dysphagia 29/143 (20%). During a mean follow-up period of 14 (8-36) months, haemoptysis recurrence was observed in 42/110 cases (38%) of cystic fibrosis and in 77/367 cases of other diseases (21%).

CONCLUSIONS

BAE and NBAE are effective and safe for acute treatment of haemoptysis, with low recurrence and complication rates. Interventional radiologist experience is crucial to the successful haemoptysis control and preventing complications.

摘要

目的

作者报告了31年来使用支气管动脉栓塞术(BAE)和/或非支气管动脉栓塞术(NBAE)治疗咯血的经验。

材料与方法

回顾性评估了1979年至2010年间因咯血接受支气管动脉造影的534例患者。其中,477例(89%)有活动性出血并接受了BAE和/或NBAE(男性295例,女性182例,年龄在12至71岁之间)。记录栓塞技术、材料、主要和次要并发症以及复发情况。

结果

458/477例(96%)患者在24小时内咯血完全缓解,2%的患者在48小时内咯血完全缓解。咯血的病因如下:囊性纤维化(23%)、支气管扩张(13%)、肺结核后遗症(8%)、慢性阻塞性肺疾病(COPD)(6%)以及无明显病因(21%)。477例患者中有3例(0.6%)出现主要并发症:中风(n = 1)、短暂性脑缺血发作(TIA)(n = 1)和短暂性四肢瘫痪(n = 1)。143/477例(30%)出现次要并发症:胸痛86/143例(60%)和吞咽困难29/143例(20%)。在平均14(8 - 36)个月的随访期内,42/110例囊性纤维化患者(38%)和77/367例其他疾病患者(21%)出现咯血复发。

结论

BAE和NBAE对咯血的急性治疗有效且安全,复发率和并发症发生率低。介入放射科医生的经验对于成功控制咯血和预防并发症至关重要。

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