双重栓塞治疗大咯血的临床应用  

Clinical application of double embolization in treatment of massive hemoptysis.

作　　者：李奋保[1] 杨瑞民[1] 张铭秋[1] 赵鹏[1] 

机构地区：[1]新乡医学院第一附属医院介入诊疗中心,河南省卫辉市453100

出　　处：《中国综合临床》2005年第10期928-929,共2页Clinical Medicine of China

摘　　要：目的探讨明胶海绵颗粒栓塞支气管动脉分支加血管栓塞胶栓塞支气管动脉主干治疗大咯血的临床价值。方法采用Seldinger技术,行超选择性支气管动脉栓塞治疗,栓塞材料先用1mm×1mm×1mm的明胶海绵颗粒,待血流缓慢或停止后,用血管栓塞胶(D-TH)栓塞供血主干。常规行患侧锁骨下动脉、肋间动脉及对侧支气管动脉造影,以了解有无多支动脉供血,发现供血血管则尽量行超选择插管栓塞治疗。结果20例均1次栓塞成功,即刻止血18例,咯血明显减少2例,有效率100%。均无严重并发症发生。结论应用血管栓塞胶栓塞支气管动脉对内科治疗无效的咯血是一种有效、安全的治疗方法。Objective To explore the clinical value of bronchial artery embolization （BAE） with medical embolism glue （D-TH） and gelfoam in the treatment of massive bemoptysis. Methods Superselective bronchial artery emoblization using gelfoam particles sized 1mm×1mm×1mm was performed by using seldinger technique, and D-TH was used to obstruct the main supply of blood after blood flow was slowed or stopped. Routine angiograpby of subclavian artery,intercoastal artery and contralateral bronchus was carried out to monitor the presence of multibranch of blood supply and to immedately treat with superselective intubation embolization if the vessels with blood supply were found. Results Embolization was achieved in 20 patients. Immediate control of bemoptysis were achieved in 18 patients and bemoptysis decreased in 2 cases,with effective rate of 100%. There were no severe complications. Conclusion BAE with TH is an effective and safe treatment of massive hemoptysis.

关 键 词：咯血 支气管动脉栓塞 血管栓塞胶 肺结核 支气管扩张 

分 类 号：R56[医药卫生—呼吸系统]