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支氣管動脈栓塞術治療大量咳血病患－四病例報告
Treatment of Massive Hemoptysis by Bronchial Arterial Embolization-4 Cases Report
摘要
許多作者定義在48小時內咳血量超過600cc就可稱之為大咳血。這類有生命危險的咳血常伴隨在病人罹患肺癌或其他肺部慢性發炎的狀況下發生。 大咳血的死亡率隨著出血的速度增加而上昇，主要是因為血塊嗆著呼吸道因而窒息死亡，所以應視為一種急症立即處理。經導管支氣管動脈栓塞術（bronchial arterial embolization簡稱BAE）是控制大量咳血的有效方法之一，尤其對於當時不適合開刀或內科治療無效的病人更可藉此達到改善病人的健康狀況使之適於開刀，或是直接止血達到延長病人生命的目的。對於手術高危險度患者，支氣管動脈栓塞術是對付大咳血的唯一緩解辦法。 台北榮民總醫院自1986年6月至1987年12月間實施了4個BAE, 2個例子完全成功，2個例子失敗。4個例子在初期都能達到止血的效果。再出血很可能是因為無數細小的側枝血管再交通之故。4例中有1例發生了兩下肢癱患的合併症。我們藉此覆閱了其他文獻，並將我們有限的經驗和建議提出來以供大家參考。
並列摘要
Massive hemoptysis is defined by many authors when hemoptysis is over 600 cc medical within 48 hours. Life-threatening hemoptysis occurs frequently in patients with bronchogenic carcinoma and chronic inflammation conditions. The mortality of massive hemoptysis depends on bleeding rate rather than disease itself. Blood suffocation is the main cause of death. It is urgent for those who are in risks of any medical uneffective management and surgery, and that will be safer for the patients to stop bleeding by bronchial arterial embolization (BAE). For high risk operative group, embolization is only a palliative method to stop massive hemoptysis. From 1986 June to 1987 December, we performed BAE in 4 massive hemoptysis cases, 2 succeeded and 2 failed. Hemoptysis can be controlled initially in all cases. Rebleeding is probably due to numerous fine collateral revascularization. One of these developed severe tragic complication of paralysis. We would like to present our limited experiences and give our points of view about BAE to those who are interested in this hardwork.