论文部分内容阅读
目的 探讨肺结核大咯血行超选择性支气管动脉栓塞 (SBAE)治疗的价值。方法 对 41例肺结核大咯血患者行SBAE ,随访 4～ 5 2个月。对复发大咯血患者再次行SBAE治疗。结果 41例患者即时止血 35例 ,即时止血率 85 .3%。一次性栓塞治愈 2 6例 ,治愈率 6 3.4%。复发 15例 ,复发率36 .6 % ,其中日咯血量 5 0 0ml以上患者复发率高于日咯血量 5 0 0ml以下者 (P <0 .0 5 ) ;合并有壁空洞和(或 )广泛纤维化患者复发率高于无空洞和 (或 )广泛纤维化者 (P <0 .0 1)。结论 SBAE应成为肺结核大咯血的首选治疗 ;合并有壁空洞和 (或 )广泛纤维化者及日咯血量 5 0 0ml以上者易复发 ;复发患者再次行SBAE后 ,无空洞和 (或 )广泛纤维化者仍可治愈 ,而合并有壁空洞和 (或 )广泛纤维化者仍易复发 ,宜行SBAE获得即时止血后择期手术切除
Objective To investigate the value of super selective bronchial artery embolization (SBAE) in the treatment of tuberculosis and hemoptysis. Methods SBAE was performed in 41 cases of pulmonary tuberculosis patients with massive hemoptysis and followed up for 4 to 52 months. Patients with recurrent hemoptysis again SBAE treatment. Results 41 cases of immediate hemostasis in 35 cases, immediate hemostasis rate of 85.3%. A one-time embolization cured 26 cases, the cure rate of 6 3.4%. The recurrence rate was higher in patients with more than 500 ml daily hemoptysis compared with those with less than 500 ml / day of hemoptysis (P <0.05). There were 15 cases with recurrence rate of 36.6% The recurrence rate of patients with fibrosis was higher than those without cavity and / or extensive fibrosis (P <0.01). Conclusions SBAE should be the first choice for the treatment of pulmonary tuberculosis with massive hemoptysis. Patients with wall cavity and / or extensive fibrosis and more than 500 ml daily hemoptysis are likely to relapse. After recurrent SBAE, the patients without recurrence and / or extensive fibrosis Can still be cured, and combined with wall cavity and (or) extensive fibrosis are still easy to relapse, appropriate SBAE immediate hemostasis after elective surgical resection