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目的 :了解支气管动脉双重栓塞术治疗不同原因咯血的效果 ,探讨肺部基础病变对该治疗技术效果的影响。方法 :追踪观察了 4 8例不同原因咯血病例在行支气管动脉双重栓塞术后 3个月内咯血复发情况。结果 :①在肺结核患者中 ,一侧或一叶损坏肺及有明显胸膜增厚粘连者 ,复发咯血的机会最多也最严重 ;而无上述情况者即使肺结核病灶较多、空洞较大 ,复发咯血的机会也较少且程度较轻。②支气管扩张症患者中反复感染者容易复发咯血。③肺叶切除术后咯血病例栓塞术后复发咯血的程度较轻。④ 5例复咯病人 3个月内再次行支气管动脉造影 ,无 1例显示原已栓塞的血管再通。结论 :支气管动脉双重栓塞术对各种原因的咯血均有较好的疗效 ,但不同的肺部基础病变疗效有差别 ,肺外体循环参与肺内病灶供血及肺部感染控制欠佳可能是致支气管动脉双重栓塞术治疗失败的主要原因。明胶海绵作为支气管动脉双重栓塞术的栓塞剂 ,其栓塞效果确切、安全、经济。
Objective: To understand the effect of double-embolization of bronchial artery in the treatment of hemoptysis of different causes and to explore the effect of basic lung disease on the therapeutic effect. Methods: The recurrence of hemoptysis in 48 cases of hemoptysis with different causes after 3 months of double bronchial artery embolization was observed. Results: ① In patients with tuberculosis, one side or one leaf damaged the lungs and obvious thickened pleural adhesions, the chance of recurrent hemoptysis is also the most serious; without these cases, even if there are more pulmonary tuberculosis lesions, large cavities, recurrent hemoptysis There are fewer and lesser degrees of opportunity. ② repeated infection in patients with bronchiectasis easily recurrent hemoptysis. ③ lobectomy patients with hemoptysis after embolization recurrence of hemoptysis to a lesser extent. ④ In 5 patients, the bronchial artery angiography was performed within 3 months again. None of the patients showed the recanalization of the embolized vessel. Conclusion: The double embolization of bronchial artery has a good curative effect on hemoptysis for various reasons, but different pulmonary basic lesion curative effects are different. Pulmonary extracorporeal circulation is involved in the supply of intrapulmonary lesions and pulmonary infection control may be caused by bronchus The main reason for the failure of arterial double embolization. Gelatin sponge as bronchial artery embolization of double embolization, the embolization effect is exact, safe and economical.