曾兰辉 顾俊菁 盛忠兰 黄玲 高俊辉 肖本山 刘冬冬 侯佩

【摘要】 目的：探討动脉介入栓塞止血术治疗中老年咯血患者的临床效果及对复发率的影响。方法：选取2019年5月-2021年5月井冈山大学附属医院收治的中老年咯血患者82例，按随机数字表法将其分为对照组与观察组，每组41例。对照组予以常规药物治疗，观察组予以动脉介入栓塞止血术治疗，随访3个月。比较两组临床疗效、支气管动脉直径、咯血量、住院时间、复发率，并记录不良事件发生率。结果：观察组总有效率为97.56%，高于对照组的80.49%（P<0.05），观察组复发率为2.50%（1/40），低于对照组的15.15%（5/33）（P<0.05）。观察组治疗后支气管动脉直径、每日咯血量均低于对照组，住院时间短于对照组，差异均有统计学意义（P<0.05）。两组不良事件发生率相比，差异无统计学意义（P>0.05）。结论：动脉介入栓塞止血术可提高中老年咯血患者治疗效果，减少咯血量，缩短住院时间，降低复发率，值得广泛应用。

【关键词】 咯血 动脉介入栓塞止血术 保守治疗 日咯血量 复发率

Clinical Efficacy of Arterial Interventional Embolization Hemostasis in the Treatment of Middle-aged and Elderly Hemoptysis Patients/ZENG Lanhui， GU Junjing， SHENG Zhonglan， HUANG Ling， GAO Junhui， XIAO Benshan， LIU Dongdong， HOU Pei. //Medical Innovation of China， 2022， 19（16）： 0-074

[Abstract] Objective： To investigate the clinical efficacy of arterial interventional embolization hemostasis in the treatment of middle-aged and elderly hemoptysis patients and its influence on the recurrence rate. Method： A total of 82 middle-aged and elderly hemoptysis patients admitted to Affiliated Hospital of Jinggangshan University from May 2019 to May 2021 were selected， and they were divided into the control group and the observation group according to the random number table method， 41 cases in each group. The control group was treated with conventional medication， and the observation group was treated with arterial interventional embolization hemostasis， two groups were followed up for 3 months. The clinical efficacy， bronchial artery diameter and hemoptysis， hospital stay， and recurrence rate were compared between the two groups， and the incidence of adverse events was recorded. Result： The total effective rate of the observation group was 97.56%， which was higher than 80.49% of the control group （P<0.05）， and the recurrence rate of the observation group was 2.50% （1/40）， which was lower than 15.15% （5/33） of the control group （P<0.05）. After treatment， bronchial artery diameter and daily amount of hemoptysis in the observation group were lower than those in the control group， and hospital stay was shorter than that in the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of adverse events between two groups （P>0.05）. Conclusion： Arterial interventional embolization hemostasis can improve the therapeutic effect of middle-aged and elderly hemoptysis patients， reduce the amount of hemoptysis， shorten the length of hospital stay， reduce the recurrence rate， it is worthy of widespread application.

[Key words] Hemoptysis Arterial interventional embolization hemostasis Conservative treatment Daily amount of hemoptysis Recurrence rate

First-author’s address： Affiliated Hospital of Jinggangshan University， Ji’an 343000， China

doi：10.3969/j.issn.1674-4985.2022.16.016

咯血多是呼吸系统疾病所致支气管、喉部等下呼吸道出血，并通过咳嗽形式经口排出，若出血量过大不仅造成呼吸道阻塞，降低气道通气能力，甚至能诱发出血性休克，对患者生命造成威胁[1-2]。目前，临床治疗咯血多以保守治疗为主，即指导患者绝对卧床休息，并在原有疾病基础上加用止血药物治疗，以减少出血量，从而稳定患者病情[3]。但常规保守治疗效果有限，止血速度慢，且存在较高复发风险[4]。随着介入技术的发展及新型材料的问世，动脉介入栓塞止血术逐渐应用于临床咯血治疗中，具有创伤小、止血速度快等特点[5]。……