Efficacy Evaluation Of Bronchial Artery Embolization And Non-bronchial Systemic Artery Embolization In The Treatment Of Pulmonary Tumor Hemoptysis

Objective:To evaluate the clinical efficacy of bronchial artery embolization and non-bronchial systemic artery embolization in the treatment of pulmonary tumor hemoptysis,and to explore the related risk factors affecting the death of patients with pulmonary tumor hemoptysis.Methods:The clinical data of 59 patients with pulmonary tumor complicated with hemoptysis admitted to the Emergency Care Unit of the Fourth Hospital of Hebei Medical University from July 2015 to October 2020 were retrospectively analyzed.The selected patients were divided into the conventional group(n=36)and the interventional group(n=23).The patients in the conventional group were treated with conventional medical conservative treatment.The patients in the interventional group were treated with bronchial artery embolization or non-bronchial systemic artery embolization on the basis of conventional medical conservative treatment.The physiological indicators,APACHE II score,clinical remission rate,in-hospital mortality,survival time,length of hospital stay,hospital costs,etc.were compared between the two groups.Cox regression analysis was used to determine the independent risk factors affecting the death of patients with pulmonary tumor hemoptysis.Results:There was no significant difference between the two groups in sex,age,APACHE II score,histological type of pulmonary tumor,tumor stage,tumor size,presence or absence of cavity,anti-tumor treatment,hemoptysis volume at 24 hours after hospitalization,hemodynamic status,plasma fibrinogen content,platelet count,hemoglobin,and endotracheal intubation(P>0.05).Clinical remission rate:95.7% in intervention group vs88.9% in conventional group;in-hospital mortality:4.3% in intervention group vs 11.1% in conventional group,but there was no statistical difference(P>0.05);six-month mortality:39.1% in intervention group vs 66.7% in conventional group,with statistical difference(P=0.035);there was no statistical difference in the length of hospital stay between the two groups(P=0.216);there was statistical difference in the cost of hospitalization between the two groups(P=0.000).The average survival time of all patients was 164 days,the average survival time of patients in the interventional group was 202 days VS 139 days in the conventional group;the survival time of all patients was 167 days,and the survival time of patients in the interventional group was 200 days VS 119 days in the conventional group;there was a statistically significant difference in the survival time between the two groups(P=0.046).The results of Cox regression analysis showed that high APACHE II score(P=0.000),no BAE or NBSAE(P=0.001),reduced plasma fibrinogen content(< 2 g/L)(P=0.002),and tumor stage IV(P=0.007)were independent risk factors for death in patients with hemoptysis due to pulmonary tumors.Conclusion:Bronchial artery embolization or non-bronchial systemic artery embolization combined with conservative medical treatment is a safe and effective treatment to control hemoptysis and prolong survival time in patients with pulmonary tumor hemoptysis.The clinical efficacy is superior to conventional conservative medical treatment.It is worthy of being applied.