| 摘要: |
| 目的 探讨Onyx胶血管内栓塞治疗急性大咯血的安全性及有效性。方法 选取2015年3月至2017年8月因急性大咯血于我院接受Onyx胶血管内栓塞治疗的患者20例，男14例、女6例，中位年龄45.5（17~73）岁，支气管扩张10例、肺结核3例、肺癌2例、血管畸形1例、不明原因4例。其中10例为外院采用常规材料栓塞术后短期内（≤ 7 d）再次咯血。统计Onyx胶血管内栓塞治疗急性大咯血的技术成功率和临床成功率，分析相关并发症，并计算近期（<3个月）、中期（3~<12个月）及远期（≥ 12个月）复发率。结果 20例患者均成功进行栓塞，术后出血均得到有效控制，技术成功率与临床成功率均达100.0%（20/20）。所有患者均未出现脊髓损伤、呼吸衰竭等严重并发症。术后中位随访时间22.5（3~42）个月，18例（90.0%）患者随访12个月以上。3例患者分别于术后1、7、15个月复发，均经内科治疗有效，未再接受血管内栓塞止血治疗。2例肺癌患者分别于术后4、10个月死于原发性肿瘤。近期复发率为5.0%（1/20），中期复发率为5.0%（1/20），远期复发率为5.6%（1/18）。结论 采用Onyx胶血管内栓塞治疗急性大咯血安全、有效。 |
| 关键词: Onyx胶 咯血 治疗性栓塞 介入性放射学 |
| DOI：10.16781/j.0258-879x.2021.03.0343 |
| 投稿时间：2020-01-13修订日期：2020-09-17 |
| 基金项目: |
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| Clinical effect of Onyx endovascular embolization in treating acute massive hemoptysis |
| SHAO Li-ming,SUN Cheng-jian*,XU Rui,ZHANG Wei,WANG Yan-hua,ZHAO Xiao-long |
(Department of Interventional Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the safety and efficacy of Onyx endovascular embolization in the treatment of acute massive hemoptysis. Methods Between Mar. 2015 and Aug. 2017, a total of 20 patients with acute massive hemoptysis received Onyx endovascular embolization in our hospital, including 14 males and 6 females, with a median age of 45.5 years (ranged 17-73 years), 10 cases of bronchiectasis, 3 cases of pulmonary tuberculosis, 2 cases of lung cancer, 1 case of arteriovenous malformation and 4 cases of cryptogenic hemoptysis. There were 10 cases experienced rebleeding after embolization with conventional agents within 7 days (transfered from other hospitals). The technical and clinical success rates and the related complications of Onyx endovascular embolization in treating acute massive hemoptysis were analyzed. The short-term (<3 months), medium-term (3-< 12 months) and long-term (≥ 12 months) recurrence rates were calculated. Results Embolization was technically and clinically successful in all the 20 patients (100.0%) and postoperative bleeding was effectively controlled. No serious complications such as spinal cord injury or respiratory failure occurred. The median follow-up time was 22.5 months (3-42 months), and 18 patients (90.0%) were followed up for more than 12 months. Three patients experienced recurrent hemoptysis at 1 month, 7 months and 15 months after initial embolization; all of them were treated effectively by internal medicine, and no further interventional hemostasis was given. Two cases died from the primary tumor of the lung at 4 months and 10 months after embolization. The recurrence rates of short-term (<3 months), medium-term (3-<12 months) and long-term (≥ 12 months) were 5.0% (1/20), 5.0% (1/20) and 5.6% (1/18), respectively. Conclusion Onyx endovascular embolization is safe and effective in the treatment of acute massive hemoptysis. |
| Key words: Onyx hemoptysis therapeutic embolization interventional radiology |
