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咯血的支气管动脉栓塞术:一项系统评价与荟萃分析。

Bronchial artery embolization for hemoptysis: A systematic review and meta-analysis.

作者信息

Zheng Zhiyuan, Zhuang Zhiquan, Yang Minjie, Luo Jianjun, Zhang Wen, Yan Zhiping, Wang Xiaolin

机构信息

Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.

Shanghai Institute of Medical Imaging, Shanghai, China.

出版信息

J Interv Med. 2021 Aug 13;4(4):172-180. doi: 10.1016/j.jimed.2021.08.003. eCollection 2021 Nov.

Abstract

OBJECTIVE

To assess the safety and efficacy of bronchial artery embolization (BAE) for hemoptysis.

METHODS AND MATERIALS

Databases with articles published in English, including Pubmed, Embase, Web of science and Chochrane library, were comprehensively searched to get accurate, up-to-date and sufficient literature about BAE for hemoptysis until March 2020. The technical success rates, immediate control rates, recurrence rates, mortality rates, and total complication rates (minor and major complication rates) extracted from the articles were pooled to estimate and assess the efficacy and safety of BAE using random-effect and fixed-effect models.

RESULTS

21 articles published between 2008 and 2019, which include a total of 2511 patients, were studied to evaluate the safety and efficacy of BAE. The technical success and immediate control rates are 99.9% (95%CI: 99%-100%) and 99.5% (95%CI: 97.8%-99.2%), respectively. This study showed hemoptysis recurrence in 23.7% (95%CI: 18.5%-28.9%) with a mortality rate of 2% (95%CI: 0-3%). Additionally, the assessment of complications revealed a total complication rate of 13.4% (95% CI: 7.6-19.2%), in which 0.2% (95% CI: 0.2-0.4%) were major complications and 10% (95% CI: 4.7-9.6%) were minor complications.

CONCLUSION

BAE is an effective, safe, and feasible procedure with a low complication rate for hemoptysis patients. However, recurrence of hemoptysis is still at high risk after BAE due to different underlying diseases.

摘要

目的

评估支气管动脉栓塞术(BAE)治疗咯血的安全性和有效性。

方法与材料

全面检索包括Pubmed、Embase、科学网和Cochrane图书馆在内的英文文献数据库,以获取截至2020年3月关于BAE治疗咯血的准确、最新且充分的文献。汇总从文章中提取的技术成功率、即时控制率、复发率、死亡率和总并发症率(轻微和严重并发症率),使用随机效应模型和固定效应模型来估计和评估BAE的有效性和安全性。

结果

对2008年至2019年间发表的21篇文章进行研究,共纳入2511例患者,以评估BAE的安全性和有效性。技术成功率和即时控制率分别为99.9%(95%CI:99%-100%)和99.5%(95%CI:97.8%-99.2%)。本研究显示咯血复发率为23.7%(95%CI:18.5%-28.9%),死亡率为2%(95%CI:0-3%)。此外,并发症评估显示总并发症率为13.4%(95%CI:7.6-19.2%),其中严重并发症为0.2%(95%CI:0.2-0.4%),轻微并发症为10%(95%CI:4.7-9.6%)。

结论

BAE是一种有效、安全且可行的治疗方法,对于咯血患者并发症发生率较低。然而,由于潜在疾病不同,BAE术后咯血复发风险仍然较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb1/8947981/f1e7fa590d3e/gr1.jpg

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