双重栓塞术治疗非肿瘤性大咯血的疗效观察

摘要

Objective To investigate the effect of dual bronchial arterial embolization in treating non neoplastic massive hemop tysis. Methods 103 patients with non neoplastic massive hemoptysis in these hospitals from January 2008 to January 2012 were se lected and divided into 3 groups. The embolization treatment group(A,35 cases) was performed the simultaneous dual arterial em bolism in the main trunk or distal end of offending vessels by polyvinyl alcohol(PVA) plus absorbable gelatin sponge within 48 h after admission. The thoracic surgery treatment group(B,30 cases) was performed the pulmonary leaf resection,pulmonary wedge resection or pneumonectomy according to tne lesion sites witnin 72 n alter admission. 1 ne medication treatment group(C,38 cases,) was given with pituitrin and phentolamin by intravenous drip and appropriately added with batroxobin by intravenous injection within 24 h after admission. The therapeutic effects were compared among 3 groups. Results The total effective rate was 88. 57% in the group A,96. 67% in the group B and 55. 26% in the group C,without statistical difference between the group A and B(P> 0. 05) ,and with statistical differences between the group A and C and between the group B and C(P<0. 05). Conclusion The dual bronchial arterial embolization has better effect for treating non neoplastic massive hemoptysis with the advantages of less pain and better tolerance.%目的 探讨支气管动脉双重栓塞治疗非肿瘤性大咯血的临床疗效.方法 选择2008年1月至2012年1月该院收治的非肿瘤性大咯血患者103例,结合病情及患者意愿分为栓塞治疗组35例,栓塞治疗组在患者入院后48 h内用聚乙烯醇(PVA)和吸收性明胶海绵联合对责任血管主干或远端同时栓塞的动脉双重栓塞术;开胸手术组30例,开胸手术组在患者入院72 h内,根据病变部位采用肺叶、肺楔形切除或全肺切除;药物治疗组38例,药物治疗组在患者入院24 h内以垂体后叶素和酚妥拉明静脉滴注,适当加用巴曲酶静脉推注.比较3组患者的治疗效果.结果 栓塞治疗组、开胸手术组和药物治疗组的总有效率分别为88.57%、96.67%和55.26%,差异有统计学意义(P＜0.05).结论 支气管动脉双重栓塞术治疗非肿瘤性大咯血疗效较好,有患者耐受好、痛苦小的优越性.