| Background and objective: Bronchial artery embolization(BAE)is an effective method to treat massive hemoptysis,which has been widely used in clinic.Fibrinogen(FIB)and D-dimer are two common indexes of coagulation and fibrinolysis system.In this study,the concentrations of FIB and D-dimer in patients with massive hemoptysis before and after BAE treatment,are compared to explore whether they can be used to evaluate the prognosis of patients with massive hemoptysis and the risk of re-hemoptysis after operation,and whether they can provide basis for prevention and control of re-hemoptysis after operation.Methods: In the sixth hospital of Wuhan,203 patients aged from 45 to 80 years old with massive hemoptysis were totally collected after they had been treated with BAE from December 2018 to December 2019.According to the hemostasis effect 24 hours after BAE,the patients were divided into four groups: excellent group(57 cases),good group(56 cases),medium group(51 cases)and poor group(39 cases).FIB and D-dimer concentrations were measured at 0.5h before operation and 24 h after operation,and the concentration changes of the two substances before and after operation were compared.At the same time,the patients were divided into four groups according to the causes of hemoptysis(pulmonary tuberculosis group,bronchiectasis group,vascular malformation group and lung tumor group),and then statistical analysis for the four therapeutic groups was carried out according to excellent effect,good effect,medium effect and poor effect respectively.The changes of D-dimer and fibrinogen concentration before and 24 hours after operation were compared.The concentrations of the patients in the optimal group were measured and compared within 5days after operation.At the same time,the complications and recurrence of the patients in the excellent effect group after BAE operation were statistically analyzed.Results: The results demonstrated that the FIB concentration before operation was significantly related to the effect of operation.The FIB concentration of the four groups after operation were higher than that before operation,and the FIB concentration of the excellent group was significantly higher than that of the poor group(P < 0.05).The concentration of D-dimer at 24 hours after operation was higher than that before operation,and there was a positive correlation between the concentration of D-dimer at 24 hours after operation and the effect of operation.There were significant differences between the excellent group and the medium group,the excellent group and the poor group(P < 0.05).The concentration of FIB and D-dimer in the same group was higher than that before operation,there was no significant difference in FIB concentration and D-dimer concentration between the four etiology groups before and after operation(P > 0.05).The total effective rate of hemostasis was 80.79% in 203 patients 24 hours after BAE.Among the four etiology groups of hemoptysis,the hemostasis effect of vascular malformation was the best,while the hemostasis effect of lung tumor was the worst.FIB and D-dimer concentrations were measured on the 2nd,3rd,4th and 5th day after the operation.The concentration of D-dimer increased in the first few days after operation,and reached the highest level on the fourth day after operation,then decreased from the fifth day after operation.FIB concentration did not change significantly within 5 days after operation.The adverse reaction rate of BAE was 11.6%(5/43).The recurrence rate within 6months was 16.3%(7/43),of which 71.4% was lung cancer.Conclusion: The concentration of FIB and D-dimer has a significant relationship with the effect of operation,which can be used as an index to evaluate the effect of operation.The change of D-dimer concentration after operation can indicate the formation of thrombus,which is of significance for the evaluation of operation effect. |
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