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目的 :探讨选择性支气管动脉明胶海绵栓塞治疗大咯血的方法及疗效。方法 :对 2 6例大咯血或顽固性咯血病人用明胶海绵颗粒 ,选择性栓塞支气管动脉。 2 6例患者中 ,19例栓塞单支支气管动脉 ,3例栓塞同侧 2支支气管动脉 ,4例行双侧支气管动脉栓塞。肺结核 13例 ,支气管扩张 7例 ,肺癌 5例 ,支气管动静脉畸形出血 1例。先行选择性支气管动脉造影 ,确定出血血管后 ,用明胶海绵颗粒栓塞 ,直到支气管动脉闭塞为止。结果 :经 2个月～ 3年随防 ,即刻止血2 2例 ,出血完全控制。 3例仍有间断性痰中带血 ,但出血量明显减少 ,出血间隔时间延长。 1例支气管动静脉畸形栓塞后出血停止 ,1周后又复发大咯血而手术切除病灶。结论 :选择性支气管动脉明胶海绵栓塞是治疗大咯血的有效手段 ,效果确切、止血迅速
Objective: To explore the method and curative effect of selective bronchial artery gelatin sponge embolization in treating massive hemoptysis. Methods: Gelatin sponge particles were used in 26 patients with massive hemoptysis or refractory hemoptysis to selectively embolize the bronchial artery. Of 26 patients, 19 had a single bronchial artery embolization, three had ipsilateral two bronchial arteries, and four had bilateral bronchial artery embolization. Pulmonary tuberculosis in 13 cases, bronchiectasis in 7 cases, lung cancer in 5 cases, 1 case of bronchial arteriovenous malformations. First selective bronchial artery angiography, blood vessels identified after the embolization with gelatin sponge particles, until the bronchial artery occlusion so far. Results: After 2 months to 3 years with prevention, immediate hemostasis in 22 cases, complete control of bleeding. 3 cases still have intermittent bloody sputum, but significantly reduced bleeding, bleeding interval extended. One case of bronchial arteriovenous malformations stopped bleeding after embolization, one week later recurrent hemoptysis and surgical removal of the lesion. Conclusion: Selective bronchial artery gelatin sponge embolization is an effective method for the treatment of massive hemoptysis, the effect is exact, rapid hemostasis