Zhang J S, Cui Z P, Wang M Q, Yang L
Department of Diagnostic Radiology, Great Wall Hospital, Beijing, China.
Cardiovasc Intervent Radiol. 1994 Sep-Oct;17(5):276-9. doi: 10.1007/BF00192451.
The purpose of this study was to determine the factors influencing the effect of bronchial artery embolization in treating massive hemoptysis and the value of bronchial arteriography in the evaluation of patients with hemoptysis.
Thirty-five patients with acute hemoptysis were evaluated by means of bronchial arteriography and treated with transcatheter embolization. Specific causes for bleeding were bronchiectasis (17), lung cancer (9), tuberculosis (4), tetralogy of Fallot (1), and idiopathic hemoptysis (4). The materials used for embolization were gelatin sponge in 33 patients, dextran microspheres in 2, and stainless coils in 1.
The angiographic signs of hemorrhage encountered were extravasation of contrast media (14.2%), hypervascularization (94.5%), bronchopulmonary shunts (34.2%), and bronchial artery aneurysms (14.2%). Immediate control of bleeding occurred in 32 (91.4%) of 35 patients after embolization. The rate of recurrent hemoptysis was 20.0% after 2 weeks of the procedure, but the hemorrhage was less severe than before treatment.
The data suggest that bronchial artery embolization is an effective method for managing patients with hemoptysis. Minor bleeding recurrences appear to be relatively frequent.
本研究旨在确定影响支气管动脉栓塞术治疗大咯血效果的因素以及支气管动脉造影在咯血患者评估中的价值。
对35例急性咯血患者进行支气管动脉造影评估并采用经导管栓塞术治疗。出血的具体病因包括支气管扩张（17例）、肺癌（9例）、肺结核（4例）、法洛四联症（1例）和特发性咯血（4例）。栓塞所用材料为33例患者使用明胶海绵，2例使用葡聚糖微球，1例使用不锈钢圈。
造影显示的出血征象包括造影剂外渗（14.2%）、血管增多（94.5%）、支气管肺分流（34.2%）和支气管动脉瘤（14.2%）。栓塞术后35例患者中有32例（91.4%）出血得到立即控制。术后2周咯血复发率为20.0%，但出血程度较治疗前减轻。
数据表明支气管动脉栓塞术是治疗咯血患者的有效方法。轻微出血复发似乎相对常见。
