中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (42): 7959-7962.doi: 10.3969/j.issn.1673-8225.2010.42.041

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

海藻酸钠微球与明胶海绵栓塞肺结核大咯血的效果比较：143例分析

黄  沁，田  媛，敖国昆，谈志远，刘杰爱   

  1. 解放军第309医院放射科，北京市  100091
  • 出版日期:2010-10-15 发布日期:2010-10-15
  • 通讯作者: 敖国昆，硕士，副主任医师，解放军第309医院放射科，北京市 100091
  • 作者简介:黄沁，女，1966年生，湖北省荆沙市人，汉族，主管技师，主要从事影像介入工作。 sjk1992@sohu.com

Comparison of sodium alginate microspheres and gelatin sponge embolization for massive hemoptysis due to pulmonary tuberculosis in 143 cases

Huang Qin, Tian Yuan, Ao Guo-kun, Tan Zhi-yuan, Liu Jie-ai   

  1. Department of Radiology, The 309 Hospital of Chinese PLA, Beijing   100091, China
  • Online:2010-10-15 Published:2010-10-15
  • Contact: Ao Guo-kun, Master, Associate chief physician, Department of Radiology, The 309 Hospital of Chinese PLA, Beijing 100091, China
  • About author:Huang Qin, Technician-in-charge, Department of Radiology, The 309 Hospital of Chinese PLA, Beijing 100091, China sjk1992@sohu.com

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摘要：

背景：在诸多治疗方案中，介入栓塞肺结核大咯血的疗效最明确、显著。而多种栓堵材料也随之而出现，从传统的明胶海绵、聚乙烯醇颗粒，到目前应用广泛的微弹簧圈、海藻酸钠微球栓塞剂，疗效各不相同。
目的：比较海藻酸钠微球与明胶海绵支气管动脉内栓塞治疗肺结核大咯血的疗效。
方法：143例肺结核大咯血患者，根据栓塞材料不同分为明胶组与海藻酸钠微球组。先行选择性支气管动脉插管造影，再做超选择支气管动脉插管，最后注入栓塞材料栓塞末梢支气管动脉。
结果与结论：明胶组共栓塞靶血管92支，44例(58.7%)患者栓塞后即刻止血，总有效率为81.3%。随访2年，复发12例(25.3%)。海藻酸钠微球组共栓塞靶血管83支，60例(89. 1%)患者栓塞后即刻止血，总有效率为92.6%。随访2年，复发5例(7.8%)。两组比较，海藻酸钠微球组即刻止血效果显著优于明胶组(P < 0.05)，治愈率显著高于明胶组(P < 0.05)；海藻酸钠微球组复发率显著低于明胶组(P < 0.05)；海藻酸钠微球组总有效率显著高于明胶组(P < 0.05)。并发症的发生率两组差异无显著性意义(P > 0.05)。结果提示，海藻酸钠微球支气管动脉栓塞治疗肺结核大咯血安全、有效，复发率低，值得临床推广应用。

关键词: 支气管动脉栓塞, 肺结核咯血, 海藻酸钠微球, 明胶海绵, 介入治疗

Abstract:

BACKGROUND: Among many treatment programs for massive hemoptysis due to pulmonary tuberculosis, the efficacy of embolization is most clear and obvious. There are a variety of plug blocking materials, such as traditional gelatin sponge, polyvinyl alcohol particles, widely used coil, sodium alginate microspheres embolic agent and so on. They have different efficacies.
OBJECTIVE: To compare the therapeutic effect of sodium alginate microspheres versus gelatin sponge embolization of bronchial artery for massive hemoptysis due to pulmonary tuberculosis.
METHODS: Totally 143 cases of massive hemoptysis due to pulmonary tuberculosis were divided into two groups according to different embolic materials, a gelatin group and a sodium alginate microsphere group. Selective bronchial artery angiography was performed first, superselective bronchial arterial cannulation was done, and finally embolic materials were into the distal bronchial artery for embolization.
RESULTS AND CONCLUSION: In gelatin group, 92 target vessels showed a thrombosis, 44 patients (58.7%) were immediately stopped bleeding after embolization, total effective rate was 81.3%. In 2-year follow-ups, 12 cases (25.3%) recurred. In sodium alginate microsphere group, 83 target vessels showed a thrombosis, and 60 patients (89.1%) were immediately stopped bleeding after embolization, total effective rate was 92.6%. In 2-year follow-ups, 5 cases (7.8%) recurred. The immediate hemostatic effect in the sodium alginate microsphere group was significantly better than that of gelatin group (P < 0.05), the cure rate was significantly higher than gelatin group (P < 0.05); the recurrence rate was significantly lower than gelatin group (P < 0.05); total effective rate was significantly higher than gelatin group (P < 0.05). There was no significant difference between two groups regarding the incidence of complications (P > 0.05). The sodium alginate microsphere for bronchial artery embolization is safe and effective to treat for massive hemoptysis due to pulmonary tuberculosis, with low recurrence rate, thus worthy of clinical application.

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