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目的探讨明胶海绵(GS)颗粒和聚乙烯醇(PVA)颗粒用于肋间支气管动脉内栓塞治疗急性大咯血的临床疗效。方法52例急性大咯血患者,先行选择性支气管动脉造影,利用同轴导管技术,用3F SP微导管超选择插管至出血支气管动脉分支,A组(24例)用GS颗粒栓塞;B组(28例)用PVA颗粒栓塞。结果A组24例患者,栓塞后即刻止血16例(66.67%),72 h内完全停止咯血7例(29.17%),栓塞止血有效率为95.83%;B组28例患者栓塞后即刻止血24例(85.71%),72 h内完全停止咯血1例(14.29%),栓塞止血有效率为100%。A、B 2组有效率无显著性差异(P(0.05)。随访1年,A组复发6例(25%),B组复发1例(3.57%),复发率有显著性差异(P(0.05)。结论肋间支气管动脉栓塞术是治疗大咯血有效方法,应用PVA颗粒为栓塞剂,安全有效,不易复发,临床疗效显著。
Objective To investigate the clinical efficacy of gelatin sponge (GS) particles and polyvinyl alcohol (PVA) particles for treatment of acute massive hemoptysis with intercostal bronchial artery embolization. Methods Fifty-two patients with acute massive hemoptysis underwent selective bronchial artery angiography. By using coaxial catheter technique, 3F SP microcatheter was cannulated to the branch of hemorrhagic bronchial artery. Group A (24 cases) was embolized with GS particles. Group B ( 28 cases) with PVA particles embolization. Results Twenty-four patients in group A had hemostasis immediately after embolization (66.67%), 7 patients (29.17%) stopped hemoptysis completely within 72 hours, and the effective rate of embolization was 95.83%. In group B, 28 patients were stopped immediately after embolization (85.71%). One patient (14.29%) stopped hemoptysis completely within 72 hours and the effective rate of embolization was 100%. There was no significant difference between groups A and B 2 (P 0.05) .After one year’s follow-up, there were 6 cases (25%) in group A and 1 case (3.57%) in group B, the recurrence rate was significantly different 0.05) .Conclusion Intercostal bronchial artery embolization is an effective method for the treatment of massive hemoptysis. The application of PVA granules as embolic agent is safe and effective, and it is difficult to relapse. The curative effect is remarkable.