Uflacker R, Kaemmerer A, Neves C, Picon P D
Radiology. 1983 Mar;146(3):627-34. doi: 10.1148/radiology.146.3.6828674.
Massive hemoptysis is a major clinical and surgical problem with a mortality of 80%, which is most often related to asphyxiation. Thirty-three patients with massive hemoptysis underwent selective bronchial arteriography and treatment by embolization or surgery. Lasting control of hemoptysis was achieved in 27 of 33 patients (81.8%) at follow-up ranging from one to 24 months. Hemoptysis recurred in six of 33 patients (18.2%). Mortality related to hemoptysis was three of 33 patients (9.0%), and overall mortality was six of 33 patients (18.2%). Seven patients underwent surgical treatment in addition to bronchial artery embolization. Patients with mycetoma suffered the highest relapse of bleeding and the highest mortality in this series. In these patients, bronchial artery embolization may be effective in the control of acute bleeding, but permanent control of hemoptysis is achieved only by later surgery. Bronchial artery embolization is an effective way to control massive hemoptysis with a low recurrence rate and reduced mortality among severely ill patients. Although we have had no unfavorable sequelae, reports of neurological damage following bronchial angiography indicate care in avoiding obstruction of the artery of Adamkiewicz.
大咯血是一个主要的临床和外科问题，死亡率达80%，这通常与窒息有关。33例大咯血患者接受了选择性支气管动脉造影，并通过栓塞或手术进行治疗。在1至24个月的随访中，33例患者中有27例（81.8%）咯血得到持久控制。33例患者中有6例（18.2%）咯血复发。咯血相关死亡率为33例患者中的3例（9.0%），总死亡率为33例患者中的6例（18.2%）。7例患者除接受支气管动脉栓塞外还接受了手术治疗。在该系列中，曲菌球患者的出血复发率最高，死亡率也最高。对于这些患者，支气管动脉栓塞可能对控制急性出血有效，但只有通过后期手术才能实现咯血的永久控制。支气管动脉栓塞是控制大咯血的有效方法，复发率低，可降低重症患者的死亡率。虽然我们没有出现不良后遗症，但支气管造影后神经损伤的报告表明，应注意避免阻塞Adamkiewicz动脉。
