目的 探讨超选择性支气管动脉栓塞治疗对矽肺伴急性大咯血的临床价值.方法 在36例矽肺伴急性大咯血的介入栓塞治疗中,双重栓塞(明胶海绵+PVA颗粒或弹簧圈)21例作为研究组.明胶海绵单—栓塞15例作为对照组,对它们中期疗效进行对照分析.结果 随访1月.研究组无复发病例,低于对照组复发咯血20％(3/1 5,)；有效率研究组达100％,高于对照组的80％(12/15).随访3个月,研究组复发9.5％(2/21)低于对照组33.3％(5/15)；有效率前者为90.5％(19/21),高于后者的66.7％(10/15).随访1 2个月,研究组复发38.1％(8/21)低于对照组复发60 ％(9/15)；有效率前者为61.9％(13/21),高于后者的40％(6/15).双重检塞介入治疗矽肺伴急性大咯血的中期疗效优于单纯采用明胶海绵栓塞治疗.结论 超选择性支气管动脉栓塞治疗在矽肺伴急性大咯血中期疗效是一种有效、安全的治疗方法.%Objective To study clinical value of the super selective bronchial arterial dual interventional therapy for silicosis with big haemoptysis. Methods In 36 patients of the silicosis with big haemoptysis intervention embolization. double embolization (gelatin sponge + PVA particle or spring circle) , (n=21) were taken as the team, single embolism(gelatin sponge). (n= 15) as control group, and contrast analysis of their middle curative effect was conducted. Results Follow-up of one month, no recurrent case in the team was lower than recurrence haemoptysis of 3 cases (3/15, 20%) in the control group; 100% of the former was higher than 80%(12/15) of the latter in the efficiency. Follow-up of 3 months, recurrence of 2 cases (2/21, 9. 5%) in the team were lower than those of 5 patients (5/15. 33. 3%) in the control group; 90. 5％(19/21) of the former was higher than 66. 7 % C10/15) of the latter in the efficiency. Follow-up of 12 months, recurrence of 8 cases (38% , 8/21) in the team were lower than those of 9 cases (60% . 9/15) in the control group; 61. 9% (13/21) of the former was higher than 40% (6/15) of the latter in the efficiency. Dual interventional therapy was better than single embolism of gelatin sponge in the middle curative effect of the silicosis with big haemoptysis. Conclusion The super selective bronchial arterial dual interventional therapy for the silicosis with big haemoptysis is an effective and safe therapeutic method
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