经股动脉导管介入支气管动脉栓塞救治难治性大咯血

目的：1996—3至2005—12期间我科与介入放射科合作，对66例内科方法未能止血的大咯血患者行支气管动脉介入栓塞术止血。观察分析止血效果及并发症。方法：患者在1250数字减影机下，经股动脉插入美国COOK公司生产的3—5FCobra导管。找到支气管动脉，造影后确定出血部位，在明确无栓塞禁忌症后，以明胶海绵粉末或PVA颗粒栓塞支气管动脉，观察止血状况及并发症。结果：总体止血率95．3％（61／64），半年内9例复发咯血，但咯血量明显减小，复发率14．1％（9／64）。仅1例栓塞后未止血。2例动静脉瘘患者不能实行栓塞。15例出现发热，占23．4％（15／64），所有患者均不同程度出现气短，吸氧后缓解。结论：支气管动脉栓塞救治难治性大咯血十分有效、可靠且较为安全。

Application of Bronchial Artery Embolization Intervention through Arteria Femoralis Catheter in the Treatment of Refractory Massive Hemoptysis

Objective: To observe and analyze the effect of haemostasis of Bronchial Artery Embolization( BAE) in the treatment of 66 patients with Refractory Massive Hemoptysis( RMH) and its complications, who were not stopped bleeding through internal medicine. Methods: Firstly, insert 3 to 5F Cobra catheter( made in COOK corporation, America) into arteria femoralis under digital subtraction radiography machine. Secondly, try to find bronchial artery and the bleeding part in it. Lastly, under no visualization of contraindication of BAE, perform BAE with spongia gelatinosa powder or polyvinyl alcohol( PVA) , observing the effect of haemostasis and complications. Results: The total rate of haemostasis was 95. 3%( 61/ 64) . Nine of 64 recurred with little hemoptysis, and the recurrence rate was 14. 1%( 9/ 64) . Only one patient didn. t stop hemoptysis, after BAE, 15 patients( 23. 4%, 15/ 64) fevered( temperature, not more than 38. 5e ) , and recovered in five days. 2 with arterio- venous fistula were not given BAE. All the patients were short of breath after BAE, but improved soon after inhaling oxygen. Conclusion: BAE is an effective, reliable and safe therapy for treating the patients with RMH.