重症咯血肺结核患者的栓塞治疗

摘要/Abstract

摘要： 目的探讨动脉造影（AG）特征和动脉栓塞（AE）对重症咯血肺结核患者的治疗价值。方法回顾性分析27例重症咯血肺结核患者的动脉造影表现、动脉栓塞效果和随访1年复发率和栓塞效果, 与同期因肺结核咯血而行手术治疗的患者进行比较。结果重症咯血肺结核患者AG表现为血管迂曲、扩张、增生, 造影剂外溢, 血管瘘形成;体循环动脉出血分支与肺动脉形成瘘在重症咯血肺结核患者中出现9例(33.3%)。23例(85.0%)患者栓塞后获得有效止血, 随访1年复发率为11.1%（3/27）。与传统手术的疗效和复发率相比, 两者差异无统计学意义, 但与传统手术的住院时间和治疗费用相比, 栓塞治疗更低, 两者差异有统计学意义。结论重症咯血肺结核患者的AG表现有一定的特征性, AE治疗疗效确切, 应作为首选治疗方法。

关键词: 咯血, 肺结核, 动脉造影, 动脉栓塞

Abstract: Objective To describe the finding of angiography and assess the efficacy of artery emblization(AE) in pulmonary tuberculosis patients with severe hemoptysis. Methods A retrospective review of angiographies and artery embolizations from 27 pulmonary tuberculosis patients (PBP)severe hemoptysis(SH) was performed, the efficacy of artery embolizations and follow-up Results in 1 year was compared with that of sugery of PBPs with SH. Results In PBPs with SH, angiograpy shows tortuosity, dilation, angiogenesis of bleeding artery, and Fistula formation between branches of systemic circulation bleeding artery and pulmonary artery or vein. 9 PBPs with SH have systemic circulation and pulmonary artery fistula(SPF). 23 PBPs with SH were effective hemostasis. 3 cases recurred in 1 year. Compared with surgery, the efficacy and hemoptysis recurrence in AE patients have no significant difference, but hospital stay and cost have significant difference. Conclusions PF is common in PBP with SH. AE is an effective treatment to use first.

Key words: Hemoptysis, Pulmonary tuberculosis, Angiography, Artery embolization

廖凤翔, 骆柘璜, 金爱芳, 漆婉玲. 重症咯血肺结核患者的栓塞治疗[J]. 新发传染病电子杂志, 2019, 4(4): 227-230.

LIAO Feng-xiang, LUO Zhe-huang, JIN Ai-fang, QI Wan-ling. Embolization treatment of severe hemoptysis in patients with pulmonary tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(4): 227-230.

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