소량객혈 환자에서 동맥색전술과 보존적치료의 비교연구

Abstract

Background Surgical intervention is known as the principle management for hemoptysis of significant amount But surgical procedure is applicable 13 only small number of patients because of increased mortality in emergency surgery and various functional and structural problems after lung resection. Bronchial artery embolization(BAE) has been used as an alternative interventional technique for immediate control of patients with increased risk for surgery due 19 recurrent or massive hemoptysis. BAE also has limitations such as recurrent bleeding after procedure and its role for the application to small amount of hemoptysis is still not established.

Method To evaluate immediate and long term effectiveness of BAE, we analysed 65 patients with hemoptysis according to therapeutic modalities they received ; BAE versus conservative management.

Results The success rate for immediate control of hemoptysis was significantly higher in BAE group with 43 cases(100%) among 43 cases compared with 17 cases(77%) among 22 cases in conservative group (p<0.001). The disease control duration was 19.5α8.06 months in BAE group and 18.8α6.06 months in conservative group(p>0.05). The therapeutic response in BAE group was 82%(36/43 cases) and 95%(21/22 cases) in conservative group(p>0.05). According to the amount of hemoptysis, the therapeutic response were seen in 91%(29/32 cases) in less than 100ml and 85%(28/33 cases) in 100~400ml (p>0.05). According to the manifestation of hemoptysis, the therapeutic response in groups of recurrent and nonrecurent were 87%(20/23 cases) and 88%(37/42 cases)(p>0.05).

Conclusion The difference of therapeutic response between BAE and conservative group in patients with small amounts of hemoptysis was not found except for immediate control of hemoptysis.