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目的探讨支气管动脉栓塞治疗大咯血的方法及疗效。方法对23例大咯血或长期反复咯血的病人用明胶海绵栓塞支气管动脉。23例病人中,支气管扩张症18例;隐源性5例。先行支气管动脉、肋间动脉造影,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。结果即刻止血18例,术后咯血完全停止;2例咯血明显减少,经内科保守治疗咯血停止;3例因支气管动脉-肺静脉瘘、肋间动脉-肺静脉瘘口大,未能作栓塞。随访6月～3年不等,1例支气管-肺静脉瘘1年后复发。结论支气管动脉栓塞是治疗大咯血的有效方法,效果确切,止血迅速。
Objective To investigate the method and efficacy of bronchial artery embolization in treating massive hemoptysis. Methods Thirty-three patients with massive hemoptysis or long-term repeated hemoptysis were treated with gelatin sponge to embolize the bronchial artery. Of the 23 patients, 18 were bronchiectasis and 5 were cryptogenic. First bronchial artery, intercostal artery angiography, blood vessels identified after the embolization with gelatin sponge particles, until the bronchial artery occlusion so far. Results Immediate hemostasis occurred in 18 cases. Hemoptysis was stopped completely after operation. Hemoptysis in 2 cases was significantly reduced, and hemoptysis was stopped after conservative treatment. In 3 cases, bronchial artery - pulmonary vein fistula and intercostal artery - pulmonary vein fistula were large and failed to embolize. Follow-up ranged from 6 months to 3 years. One case of bronchogenic-pulmonary venous fistula recurred after one year. Conclusion Bronchial artery embolization is an effective method for the treatment of massive hemoptysis. The effect is exact and the hemostasis is rapid.