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支气管动脉栓塞术在咯血治疗中的应用——一所三级大学医院的回顾性分析

Bronchial artery embolisation in management of hemoptysis--A retrospective analysis in a tertiary university hospital.

作者信息

Dabó H, Gomes R, Marinho A, Madureira M, Paquete J, Morgado P

机构信息

Serviço de Pneumologia do Centro Hospitalar do São João, Porto, Portugal.

Serviço de Pneumologia do Hospital Sousa Martins, Unidade Local de Saúde, Guarda, Portugal.

出版信息

Rev Port Pneumol (2006). 2016 Jan-Feb;22(1):34-8. doi: 10.1016/j.rppnen.2015.09.001. Epub 2015 Oct 26.

Abstract

BACKGROUND

Bronchial artery embolisation (BAE) becomes a mainstay in the treatment of hemoptysis.

OBJECTIVE

To characterise patients with hemoptysis undergoing bronchial artery angiography (BAA) for embolisation, evaluating outcomes.

METHODS

We retrospectively evaluated patients with acute severe or chronic recurrent hemoptysis admitted to the Pulmonology department and submitted to BAA for purpose of embolisation.

RESULTS

A total of 88 patients were submitted to BAA, 47 (53.4%) were male, with a mean age of 61.4 ± 15.8 years. In 64 (72.7%) patients, hemoptysis presented as chronic recurrent episodes. Hemoptysis was considered severe in 40 (45.5%) patients. Bronchiectasis (other than cystic fibrosis) (n=35; 38.0%) and tuberculosis sequelae (n=31; 35.2) were the major aetiology for hemoptysis. The main angiographic abnormality was hypertrophy and tortuosity (n=68; 77.3%). BAE was performed in 67 (76.1%) of the 88 patients submitted to BAA. Immediate success was achieved in 66 (98.5%) patients. Recurrence of hemoptysis occurred in 25 (37.3%) patients, and was related to presence of shunting (p=0.049). The procedure-related complications were self-limited.

CONCLUSION

Our results suggest that BAE is a safe and effective treatment for acute severe and chronic recurrent hemoptysis, supporting the current literature. Besides this, bleeding recurrence was relatively high, and correlated with presence of systemic pulmonary shunting.

摘要

背景

支气管动脉栓塞术(BAE)已成为咯血治疗的主要手段。

目的

对因咯血接受支气管动脉造影(BAA)以进行栓塞治疗的患者进行特征分析,并评估治疗结果。

方法

我们回顾性评估了呼吸内科收治的因急性严重或慢性复发性咯血而接受BAA以进行栓塞治疗的患者。

结果

共有88例患者接受了BAA,其中47例(53.4%)为男性,平均年龄为61.4±15.8岁。64例(72.7%)患者的咯血表现为慢性复发性发作。40例(45.5%)患者的咯血被认为是严重的。支气管扩张(非囊性纤维化)(n=35;38.0%)和肺结核后遗症(n=31;35.2%)是咯血的主要病因。主要的血管造影异常为血管增粗和迂曲(n=68;77.3%)。88例接受BAA的患者中有67例(76.1%)进行了BAE。66例(98.5%)患者立即获得成功。25例(37.3%)患者出现咯血复发,且与分流的存在有关(p=0.049)。与手术相关的并发症为自限性。

结论

我们的结果表明,BAE是治疗急性严重和慢性复发性咯血的一种安全有效的方法,与现有文献一致。此外,出血复发率相对较高,且与体肺分流的存在相关。

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