Rabkin J E, Astafjev V I, Gothman L N, Grigorjev Y G
Radiology. 1987 May;163(2):361-5. doi: 10.1148/radiology.163.2.3562815.
A group of 306 patients with acute pulmonary hemorrhage were evaluated by means of bronchial arteriography and treated with transcatheter embolization. Specific causes for bleeding included lung abscess, chronic pneumonia, tuberculosis, lung cancer, and bronchiectasis. In 120 patients the hemoptysis was massive, with volumes exceeding 500 ml/day. The majority (n = 225) were treated during peak hemorrhage. Embolization was performed with one of three methods: particulate embolization with polyurethane or velour, obturation with the angiographic catheter combined with peripheral embolization by means of infused albumin macroaggregates, and regional infusion of sclerosing agents. Effective hemostasis was obtained initially in 278 patients (90.8%), including 87.5% of those treated during peak hemorrhage. In 26 of 28 cases without initial response, the pulmonary artery was the source of bleeding. Recurrent bleeding, within 1-4 days, requiring surgery was observed in 39 patients with initially successful hemostasis. Of 158 patients who were treated without surgery, subsequent episodes of hemoptysis occurred in 36. Combined methods of embolization may improve the efficacy of treatment of operable and inoperable patients with lung disease complicated by hemorrhage.
对306例急性肺出血患者进行了支气管动脉造影评估，并采用经导管栓塞术进行治疗。出血的具体原因包括肺脓肿、慢性肺炎、肺结核、肺癌和支气管扩张。120例患者咯血量大，每天咯血量超过500毫升。大多数患者（n = 225）在出血高峰期接受治疗。栓塞采用三种方法之一进行：用聚氨酯或天鹅绒进行颗粒栓塞、用血管造影导管闭塞并通过注入白蛋白大聚体进行外周栓塞、局部注入硬化剂。最初在278例患者（90.8%）中实现了有效止血，其中包括在出血高峰期接受治疗患者中的87.5%。在28例最初无反应的病例中，26例的出血源为肺动脉。在最初止血成功的39例患者中，观察到1 - 4天内出现复发性出血，需要进行手术。在158例未接受手术治疗的患者中，36例随后出现咯血复发。联合栓塞方法可能会提高对合并出血的可手术和不可手术肺部疾病患者的治疗效果。
