肺结核咯血经支气管动脉栓塞治疗后复发危险因素分析.docVIP

肺结核咯血经支气管动脉栓塞治疗后复发危险因素分析 　　【摘要】 目的：分析肺?Y核咯血经支气管动脉栓塞治疗后复发的危险因素。方法：选取2014年 　　5月-2015年4月在武汉肺科医院进修期间收治的肺结核咯血患者68例为研究对象，患者均行支气管动脉栓塞治疗，将术后1～30 d咯血复发者纳入观察组（38例），未复发者纳入对照组（30例）。对比两组肺结核类型、单用明胶海绵颗粒（GSP）、过度紧张/焦虑、活动不当、剧烈咳嗽、合并症等。分析观察组咯血复发时间特征，同时应用Logistics多元回归法分析导致肺结核咯血经支气管动脉栓塞治疗后复发的独立危险因素。结果：观察组中慢性纤维空洞性肺结核、单用GSP、过度紧张/焦虑、活动不当、剧烈咳嗽、合并症比例明显高于对照组，两组比较差异均有统计学意义（P0.05）。观察组中38例咯血复发患者，咯血时间在术后4～10 d比例为63.16%明显高于术后1～3 d 21.05%及术后10～30 d 15.79%，比较差异均有统计学意义（P0.05）。多因素回归分析显示肺结核类型、单用GSP、合并症为导致复发的独立危险因素（P0.05）。结论：引起肺结核咯血经支气管动脉栓塞治疗后复发的因素较多，咯血复发多集中在术后4～10 d，其中肺结核类型、单用GSP、合并症为导致复发的独立危险因素。 　　【关键词】 肺结核咯血； 支气管动脉栓塞； 复发； 危险因素 　　【Abstract】 Objective：To analyze the risk factors for recurrence of hemoptysis after bronchial artery embolization in patients with pulmonary tuberculosis.Method：68 patients with hemoptysis of pulmonary tuberculosis were selected as the research objects，they were admitted in Wuhan Pulmonary Hospital during the training period from May 2014 to April 2015.All patients were treated by bronchial artery embolization，they were divided into two groups according to whether recurrence of hemoptysis after operation，observation group （occurred，n=38） and control group （not occurred，n=30）.Tuberculosis types，with gelfoam particles （GSP），nervousness or anxiety，improper activities，severe coughing，complications and so on of two groups were compared.Recurrence time characteristics of hemoptysis was analyzed in observation group.At the same time，applied Logistics multiple regression analysis to analysis the independent factor caused recurrence after operation.Result：Chronic fibro-cavitary pulmonary tuberculosis，the proportion of single Gelfoam particles （GSP），excessive nervousness or anxiety，early activity or improper activity，acute cough，and complications in observation group were all significantly higher than the control group，the differences were statistically significant（P 　　【Key words】 Pulmonary tuberculosis hemoptysis； Bronchial artery embolization； Recurrence； Risk factors 　　First-a