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目的 评价明胶海绵栓塞支气管动脉对大咯血病人的疗效。方法 利用明胶海绵栓塞 5 2例大咯血或顽固性咯血病人的支气管动脉 ,其中 45例栓塞单支支气管动脉 ,3例栓塞同侧两支支气管动脉 ,4例行双侧支气管动脉栓塞。 5 2例病人 ,其中肺结核 38例 ,支气管扩张 9例 ,肺癌 4例。支气管动静脉畸形出血 1例。结果 经 3个月～ 9年的随访 ,47例栓塞后咯血完全控制 ,4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 ,但 48h后发生急性大咯血窒息死亡。结论 明胶海绵栓塞支气管动脉是治疗大咯血和顽固性咯血的有效手段。
Objective To evaluate the curative effect of gelatin sponge embolized bronchial artery on patients with severe hemoptysis. Methods Fifty-two patients with massive hemoptysis or intractable hemoptysis were treated with gelatin sponge. Forty-five patients received single bronchial artery embolization, three patients with two bronchial arteries in the same side and four patients with bilateral bronchial artery embolization. 52 cases of patients, including tuberculosis in 38 cases, bronchiectasis in 9 cases, 4 cases of lung cancer. Bronchial arteriovenous malformation hemorrhage in 1 case. Results After 3 months to 9 years of follow-up, 47 patients had complete control of hemoptysis after embolization, and 4 patients still had intermittent bloody sputum, but the amount of bleeding was significantly reduced and the interval of bleeding was prolonged. One case of bronchial arteriovenous malformations stopped bleeding after embolization, but died of acute massive hemoptysis and asphyxia 48h later. Conclusion Gelatin sponge embolization of the bronchial artery is an effective treatment of massive hemoptysis and intractable hemoptysis.