CAJ | 학술논문

目的：探讨大咯血患者在行支气管动脉栓塞（BAE）后联合应用垂体后叶素是否可以提高止血效果。方法：回顾性分析34例大咯血患者的临床资料。根据BAE后是否联合应用垂体后叶素分为联合组和对照组。譹訛联合组：在BAE后将垂体后叶素按0.1U/kg/h剂量持续静脉滴注或静脉泵入。譺訛对照组：BAE后不再应用垂体后叶素及其它止血药物。观察两组患者控制出血的有效率和不良反应。结果：譹訛联合组DSA有12例（63.2%）可见明确的对比剂外溢；全部患者可以见到病变侧支气管动脉增粗扩张，走形迂曲，杂乱；有7例为双侧出血，其余12例为单侧病变。对照组8例（53.3%）有对比剂外溢表现；有5例为双侧病变，另10例为单侧病变。譺訛联合组控制出血的总有效率89.47%，对照组总有效率为60.0%，联合组总有效率显著优于对照组(P<0.05)。譻訛联合组不良反应的发生率高于对照组，但通过对症处理和停药后症状消失。结论：在BAE的基础上联合应用小剂量的垂体后叶素显著减少了再出血风险，提高了BAE的成功率。
목적：탐토대각혈환자재행지기관동맥전새（BAE）후연합응용수체후협소시부가이제고지혈효과。방법：회고성분석34례대각혈환자적림상자료。근거BAE후시부연합응용수체후협소분위연합조화대조조。호와연합조：재BAE후장수체후협소안0.1U/kg/h제량지속정맥적주혹정맥빙입。의와대조조：BAE후불재응용수체후협소급기타지혈약물。관찰량조환자공제출혈적유효솔화불량반응。결과：호와연합조DSA유12례（63.2%）가견명학적대비제외일；전부환자가이견도병변측지기관동맥증조확장，주형우곡，잡란；유7례위쌍측출혈，기여12례위단측병변。대조조8례（53.3%）유대비제외일표현；유5례위쌍측병변，령10례위단측병변。의와연합조공제출혈적총유효솔89.47%，대조조총유효솔위60.0%，연합조총유효솔현저우우대조조(P<0.05)。앵와연합조불량반응적발생솔고우대조조，단통과대증처리화정약후증상소실。결론：재BAE적기출상연합응용소제량적수체후협소현저감소료재출혈풍험，제고료BAE적성공솔。
Objective:To investigate efficacy of bronchial artery embolization combined with Pituitrin in the treat-ment of m assive hemoptysis. Methods:the clinical data of 38 patients with massive hemoptysis were retrospectively analyses. The patients were divided into Combined group and Control group according to whether the combined appli-cation of Pituitary and BAE. Combined group was administrated with BAE and Pituitary, and Control group BAE alone. The efficacy and side effect were compared between two groups. Results:①extravasation of contrast were seen in 12 pa-tients(63.2%)in Combined group and 8 patients(53.3%)in Control group on digital subtraction angiography (DSA).②The total efficiency was 89.47% in Combined group and 60% in Control group. There was significantly differen ce ( P<0.05), also, the side effect is higher in Combined group, but it was mild and controllable. Conclusion:the application of small dose Pituitrin combined with BAE may obviously improve the efficiency and reduce the risk of rebleeding.