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一项关于支气管动脉栓塞治疗大咯血的回顾性研究:与咯血复发相关的危险因素。

A retrospective study on the management of massive hemoptysis by bronchial artery embolization: risk factors associated with recurrence of hemoptysis.

机构信息

Department of Intervention, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.

Department of Vascular Surgery, Chui Yang Liu Hospital affiliated to Tsinghua University, Beijing, China.

出版信息

BMC Pulm Med. 2023 Mar 16;23(1):87. doi: 10.1186/s12890-023-02371-1.

Abstract

BACKGROUND

Massive hemoptysis is a life-threatening condition that requires immediate treatment. This study aimed to retrospectively analyze the outcome of bronchial artery embolization (BAE) for massive hemoptysis, as well as potential factors that may contribute to the recurrence of hemoptysis after BAE.

METHODS

A total of 105 patients with massive hemoptysis treated with BAE were analyzed.

RESULTS

The immediate control rate of bleeding was 84.8% (67/79); however, during the 36-month follow-up, 45.3% (29 out of 64) of the patients had recurrent hemoptysis after BAE. Comorbidities, pituitary hormone treatment, the angiographic appearance of artery dilation and hypertrophy, and the materials used for BAE were significantly correlated with the success rate of the BAE, while lack of pituitary hormone treatment and existence of arterio-arterial or arteriovenous fistula were risk factors for the recurrence of hemoptysis after BAE. Only a small proportion of patients (9/105, 8.6%) had mild complications after BAE treatment.

CONCLUSION

Findings suggest that BAE continues to be an effective treatment for massive hemoptysis in emergency settings. Moreover, the treatment of underlying pulmonary diseases and comorbidities is important to increase BAE's success rate of BAE and decrease the risk of recurrent hemoptysis after BAE.

摘要

背景

大咯血是一种危及生命的病症,需要立即进行治疗。本研究旨在回顾性分析支气管动脉栓塞(BAE)治疗大咯血的结果,以及可能导致 BAE 后咯血复发的潜在因素。

方法

共分析了 105 例接受 BAE 治疗的大咯血患者。

结果

即刻止血率为 84.8%(67/79);然而,在 36 个月的随访中,45.3%(29/64)的患者在 BAE 后出现咯血复发。合并症、垂体激素治疗、动脉扩张和肥大的血管造影表现以及 BAE 中使用的材料与 BAE 的成功率显著相关,而缺乏垂体激素治疗和存在动静脉或动静脉瘘是 BAE 后咯血复发的危险因素。只有少数患者(9/105,8.6%)在 BAE 治疗后出现轻微并发症。

结论

研究结果表明,BAE 仍然是急诊治疗大咯血的有效方法。此外,治疗基础肺部疾病和合并症对于提高 BAE 的成功率和降低 BAE 后咯血复发的风险非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a647/10018857/762b237d8a53/12890_2023_2371_Fig1_HTML.jpg

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