The Technical Exploration And Efficacy Observation Of Stepwise Multiple Embolization Treatment For Refractory Hemoptysis

Objective: To investigate main technical points of individualized step-by-step multiple embolization of treatment for refractory hemoptysis and do the assessment of clinical effects of the embolization methods as well as analyze the influence of systemic pulmonary shunt on therapy after operation.Methods: To retrospectively analyze materials of 103 patients treated by Individualized Stepwise Multiple Embolization. According to disease categories, to do individualized stepwise multiple embolization treatment with polyvinyl alcohol and loaded sodium alginate microspheres as basic embolization agent, after to confirm type, number, abnormal branch, pulmonary circulation and systematic pulmonary shunt of targeted vessels through radiography. To judge short, medium and long term efficacy in terms of recovery situation of patients’ hemoptysis symptom after operation. To evaluate efficacy of individualized stepwise multiple embolization treatment for refractory hemoptysis by means of Kaplan-Meier survival curves. Concerning the features of target vessels to supply blood, to classify patients into with SPS and with SPS and make a contrast of effective rate and time using Log-Rank test.Results: Out of 103 patients, 215 target vessels were tested, among which individualizedstepwise multiple embolization was for 196 target vessels, and peripheral embolization for 8 ones as well as were treated in100 patients. A visit after operation was made to 103 patients for 6 to 50 months, and medium visit for 21 months. It is found that rate of instantly stopping blood was 97.1%(100/103).94.5%、93.2%、89.7%、88.9%、85.2% and 76.6% was respectively effective rates of patientsone, three and six months and one, two and three years after operation. In 103 patients, ones with SPS were 22 persons, ones without SPS 81 persons. One-year effective rates with and without SPS were(69.5±0.11)% and(98.3±0.03)%; Total effective rates with and without SPS were 55.6% and 82.7% separately.); their medium times were respectively 25(24.8±3.37)months and 42(42.2±1.50) months. And it was thought that the effective rates and times had statistical significance(2c =11.662,P<0.01).Conclusions: In terms of type, quality, structure, shape and communication situation of responsible vessels, using individualized step-by-step multiple embolization to seize and embolize them not only timely and efficiently controls hemoptysis, also remarkably reduce early and long-term recurrent rates due to recanalization of responsible vessels and establishment of collateral circulation. The existence of SPS influenced on clinical effects of the embolized technology, so please check and find SPS at the time of radiography, and do individualized embolization on the basis of its structural features and at utmost efforts seize embolized effects and improve effects after operation.