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目的分析锁骨下动脉及分支栓塞对肺结核大咯血临床疗效的影响。方法 257例肺结核大咯血患者根据治疗方法分为两组:对照组103例,行支气管动脉和肋间动脉分支栓塞;治疗组154例,行支气管动脉、肋间动脉造影、锁骨下动脉分支栓塞。观察两组临床疗效,术后反应及并发症。结果治疗组和对照组有效率分别为94.2%和80.6%,差异有统计学意义(P<0.05);复发率分别为3.2%和11.7%,差异有统计学意义(P<0.05);患者术后有胸背痛或发热,无脊髓损伤及异位栓塞等并发症出现。治疗组和对照组疼痛发生率分别为66.9%和48.5%,差异有统计学意义(P<0.05)。但严重疼痛发生率分别为7.8%和2.9%,没有统计学差异(P>0.05)。结论锁骨下动脉分支栓塞可明显提高有效率,降低复发率。
Objective To analyze the effect of subclavian artery and branch embolization on clinical curative effect of tuberculosis massive hemoptysis. Methods A total of 257 pulmonary tuberculosis patients with hemoptysis were divided into two groups according to the treatment methods: control group (n = 103) with bronchial artery and intercostal artery embolization; and treatment group (n = 154) with bronchial artery, intercostal artery angiography and subclavian branch embolization. The clinical efficacy, postoperative response and complications of the two groups were observed. Results The effective rates in the treatment group and the control group were 94.2% and 80.6%, respectively, with significant differences (P <0.05); the recurrence rates were 3.2% and 11.7%, respectively, with significant differences (P <0.05) After chest pain or fever, no spinal cord injury and ectopic embolism and other complications appear. The incidence of pain in the treatment group and control group were 66.9% and 48.5%, respectively, with significant difference (P <0.05). However, the incidence of severe pain was 7.8% and 2.9%, respectively, with no significant difference (P> 0.05). Conclusion Subclavian artery branch embolization can significantly improve the efficiency and reduce the recurrence rate.