Department of Respiratory Medicine, Chinese People's Liberation Army General Hospital, Beijing, China.
Am J Med Sci. 2014 Sep;348(3):204-9. doi: 10.1097/MAJ.0000000000000226.
Bronchial artery embolization (BAE) is widely used for the treatment of hemoptysis. The immediate and long-term results of BAE for hemoptysis in patients with benign and malignant pulmonary diseases were inconsistent in previous studies and were thus investigated.
This was a retrospective review of the clinical records of 154 patients (108 with benign disease and 46 with malignant disease) who received BAE for hemoptysis from January 2005 to June 2011 at the Chinese People's Liberation Army General Hospital.
Immediate cessation of hemoptysis was achieved in 98 patients with benign disease (90.7%) and 42 patients with malignancy (91.3%). The long-term control rate of hemoptysis in patients with benign disease was 74.3% (80/108) at 1 year, significantly higher than in patients with cancer (16/46, 35.5%, P < 0.01). The worst outcomes in the benign and malignant groups were observed in patients with aspergilloma and squamous cell lung cancer, respectively. The average number of abnormal vessels on bronchial arteriography was higher in the benign group than in the malignant group (3 ± 1.3 versus 2 ± 1.1, respectively, P < 0.01). Moreover, recurrent hemoptysis was independently associated with the presence of massive hemoptysis and bronchial-pulmonary artery shunt in both groups (P < 0.05).
BAE is a relatively safe procedure for patients with hemoptysis. Immediate control of hemoptysis with BAE is achieved in most cases, but the long-term hemoptysis control rate is worse in malignant lung diseases than in benign conditions, especially among patients with squamous cell lung cancer.
支气管动脉栓塞术(BAE)广泛用于咯血的治疗。既往研究中,BAE 治疗良、恶性肺部疾病所致咯血的即刻和长期疗效结果并不一致,因此对此进行了研究。
这是对 2005 年 1 月至 2011 年 6 月期间在中国人民解放军总医院因咯血行 BAE 治疗的 154 例患者(良性疾病 108 例,恶性疾病 46 例)的临床记录进行的回顾性分析。
良性疾病患者中 98 例(90.7%)和恶性疾病患者中 42 例(91.3%)即刻停止咯血。良性疾病患者 1 年时咯血的长期控制率为 74.3%(80/108),显著高于恶性疾病患者(16/46,35.5%,P<0.01)。在良性和恶性疾病组中,最差的结果分别见于曲霉菌病和鳞状细胞肺癌患者。支气管动脉造影显示,良性疾病组的异常血管数量高于恶性疾病组(分别为 3±1.3 与 2±1.1,P<0.01)。此外,两组中大量咯血和支气管-肺动脉分流的存在与复发性咯血独立相关(P<0.05)。
BAE 是咯血患者较为安全的治疗方法。大多数情况下,BAE 可即刻控制咯血,但恶性肺部疾病的长期咯血控制率比良性疾病差,尤其是鳞状细胞肺癌患者。