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目的 探讨气道内球囊压迫与支气管动脉栓塞术治疗老年患者大咯血的疗效及安全性。 方法 6 8例经常规内科治疗无效的老年大咯血患者 ,分为气道内球囊压迫组 (球囊组 )和支气管动脉栓塞组 (栓塞组 ) ,其中球囊组 33例 ,栓塞组 35例 ,对两种治疗方法的疗效、费用、复发率及并发症进行对比。 结果 止血率 :球囊组为 90 9% ,栓塞组为 82 9% ,球囊组稍高于栓塞组 ,但两组比较差异无显著性 (P >0 0 5 )。止血时间 :球囊组为 (2 7± 1 7)h ,栓塞组为 (6 3± 2 8)h ,两组比较差异有显著性 (P <0 0 5 )。手术费用 :球囊组为 (4 32 6± 90 7)元 ,与栓塞组 (6 80 3± 16 5 3)元比较差异有显著性 (P <0 0 5 )。 6个月复发情况 :球囊组为 2 3 3% ,栓塞组为 13 8% ,球囊组稍高于栓塞组 ,但两组比较无统计学意义 (P >0 0 5 )。并发症 :球囊组为 2 1 2 % ,栓塞组为 2 5 7% ,两组比较差异无显著性 (P >0 0 5 )。 5例单一治疗方法无效的患者联合另一种方法 ,结果 3例治疗有效。 结论 气道内球囊压迫与支气管动脉栓塞均为治疗常规内科处理无效的老年患者大咯血的理想方法 ,但前者更优 ,两种治疗方法结合可提高疗效。
Objective To investigate the efficacy and safety of endobronchial balloon compression and bronchial artery embolization in the treatment of elderly patients with hemoptysis. Methods Sixty-eight elderly patients with massive hemoptysis, who were treated with conventional medical therapy, were divided into two groups: balloon group (embolization group) and bronchial artery embolization group (embolization group), including 33 cases in balloon group, 35 cases in embolization group, The efficacy, cost, recurrence rate and complications of the two treatment methods were compared. Results The rate of hemostasis was 90.9% in balloon group, 82.9% in balloon group and slightly higher in balloon group than in embolization group. There was no significant difference between the two groups (P> 0.05). The bleeding time was (2 7 ± 1 7) h in balloon group and (6 3 ± 2 8) h in embolization group, there was significant difference between the two groups (P <0.05). Surgical cost: The balloon group was (4 32 6 ± 90 7) yuan, which was significantly different from that of the embolization group (6 80 3 ± 16 5 3) yuan (P 0 05). 6 months recurrence: balloon group was 23.3%, embolization group was 13.8%, balloon group slightly higher than the embolization group, but the two groups was not statistically significant (P> 0.05). The complication rate was 21.2% in balloon group and 25.7% in embolism group, there was no significant difference between the two groups (P> 0.05). Five patients with a single treatment of ineffective combination of another method, the results of 3 cases of effective treatment. Conclusions Airway balloon compression and bronchial artery embolization are both ideal methods for the treatment of hemoptysis in elderly patients who are ineffective in conventional medical treatment. However, the former is better and the combination of the two treatment methods can improve the curative effect.