摘要
目的总结支气管动脉栓塞术(BAE)治疗大咯血患者的1年随访结果,分析BAE对大咯血的治疗效果、安全性以及术后1年随访期间复发的危险因素。方法收集2019年1月至2022年5月阜阳市第二人民医院收治并完成术后1年随访的136例大咯血患者的临床资料。收集所有患者BAE术前的基线资料、BAE术中相关信息及随访结果,统计分析BAE治疗大咯血的即刻止血率、术后并发症发生情况以及术后1个月和术后1年随访期间大咯血的复发率。按照术后1年内是否复发将患者分为复发组(n=43)和对照组(n=93)。对可能与大咯血患者术后1年随访期间复发有关的危险因素进行单因素分析,将差异有统计学意义的指标纳入多因素Logistic回归模型,进一步分析大咯血患者术后1年随访期间大咯血复发的危险因素。结果术后住院期间的并发症主要包括胸闷(23例)、胸痛(18例)和咳嗽(15例)等,均较轻微,经过观察或对症治疗均可在住院期间逐渐缓解并消失。单因素分析结果显示,复发组患者的年龄大于对照组患者,合并支气管扩张、合并肺部空洞、有吸烟史的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄较大、有吸烟史、合并支气管扩张和合并肺部空洞均为BAE术后1年随访期间大咯血复发的独立危险因素(P﹤0.05)。结论大咯血患者BAE术后随访期间的复发率较高,与术后1年内复发有关的危险因素包括年龄较大、合并支气管扩张、合并空洞和有吸烟史,临床中应重视具有这些危险因素的患者,做好监测和预防。
Objective To summarize the 1-year follow-up results of bronchial artery embolization(BAE)for the treatment of massive hemoptysis,analyze the therapeutic effect,safety,and risk factors for recurrence during the 1-year follow-up period after BAE.Method The clinical data of 136 cases patients with massive hemoptysis admitted to the Fuyang Second People's Hospital from January 2019 to May 2022 and completed one-year follow-up after surgery were collected.The baseline data before BAE surgery,relevant information during BAE surgery,and follow-up results from all patients were collected,the immediate hemostasis rate,incidence of postoperative complications,and recurrence rate of hemoptysis during the 1-month and 1-year follow-up period of BAE treatment for severe hemoptysis were counted and analyzed.The patients were divided into recurrence group(n=43)and control group(n=93)based on whether they recurred within 1 year after surgery.Univariate analysis was conducted on the risk factors that may be associated with recurrence in patients with massive hemoptysis during the 1-year follow-up period after surgery,and the indicators with statistically significant differences were included in multivariate Logistic regression model to further analyze the risk factors for recurrence in patients with massive hemoptysis during the 1-year follow-up period after surgery.Result The complications during postoperative hospitalization mainly include chest tightness,chest pain,cough and so on,all of which were relatively mild,after observation or symptomatic treatment,they can gradually alleviate and disappear during hospitalization.The results of univariate analysis showed that the age of patients in the recurrence group was higher than that of patients in the control group,and the proportion of patients with concurrent bronchiectasis,concurrent pulmonary cavities,and smoking history were higher than those of patients in the control group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that older age,smoking history,concurrent bronchiectasis,and concurrent pulmonary cavities were independent risk factors for massive hemoptysis recurrence during the 1-year follow-up period after BAE surgery(P<0.05).Conclusion Patients with severe hemoptysis have a higher rate of recurrence during the follow-up period after BAE surgery.Risk factors related to recurrence within one year after surgery include older age,concurrent bronchiectasis,concurrent pulmonary cavities,and smoking history.In clinical practice,patients with these risk factors should be valued and monitored and prevented.
作者
张智勇
陈雷
李龙朋
王志雷
Zhang Zhiyong;Chen Lei;Li Longpeng;Wang Zhilei(Department of Interventional Radiology,Fuyang Second People's Hospital,Fuyang 236015,Anhui,China)
出处
《血管与腔内血管外科杂志》
2025年第3期374-377,391,共5页
Journal of Vascular and Endovascular Surgery
基金
北京医学奖励基金会课题研究项目(YXTL-2021-0319-0404)。
关键词
大咯血
支气管动脉栓塞术
疗效
复发
危险因素
massive hemoptysis
bronchial artery embolization
efficacy
recurrence
risk factor
