如何安全有效栓塞支气管动脉控制大咯血  

How to control heavy hemoptysis effectively and safely by bronchial artery embolism

作　　者：王巧兮[1] 吴向东 韩艺东[1] 胡红耀[1] 王劲琪[3] 

机构地区：[1]武汉大学人民医院放射科,湖北武汉430060 [2]浠水县人民医院放射科,湖北浠水436200 [3]黄石市三医院放射科,湖北黄石435000

出　　处：《中国介入影像与治疗学》2006年第2期108-111,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨一次性安全有效地支气管动脉栓塞（BAE）控制大咯血。方法226例大咯血患者（男188例，女38例）中，肺结核69例，支扩147例，其他10例。经皮穿刺右股动脉插管将导管端置于出血动脉内，并经造影证实后，行出血动脉栓塞术。结果BAE术226例中单纯支气管动脉123例，1～2支以上肋间动脉13例，多支出血65例，支气管动脉造影（BAG）显示B-P分流6例，9例术中应用血管扩张剂（654—2），支气管动脉与纵隔动脉共于30例。无一例脊髓损伤及复发出血等并发症。结论本组226例BAE术经验表明，无论是多支出血、B-P分流，出血动脉与纵隔动脉共于等复杂情况，特别是在无DSA装置条件下行BAG及BAE术时先经导管注入适量不同粗细明胶海绵糊，观察血流动态，再注入聚乙烯醇（PVA）是一种实用、安全、有效的方法，值得推广。Objective To discuss the value of controlling hemoptysis by bronchial artery embolism （BAE）. Methods Among 226 cases of hemoptysis （188 male and 38 female）, 69 caused by pulmonary tuberculosis, 147 caused by bronchiectasis, 10 by other reasons. Confirmed by transfemoral artery cauterization angiogaphy, we embalmed the bleeding artery. Results Among 226 cases of BAE, single bronchial artery involved in 123, one or two intercostals arteries involved in 13, multiple arteries involved in 65, B-P shunt in 6, the common trunk in bronchial artery and mediastinal artery in 30. No complications such as spinal injury and re-bleeding occurred. Conclusion To our experience of BAE, it is an effective and advisable bleeding-controlling method that injecting polyrinyl alchohol （PVA） after giving amount of gelatine spouge with different thickness by catheter, no matter in such complicated circumstance as multiple artery bleeding, B-P shunt, common trunk, and even in circumstance without DSA instrument when BAG or BAE is performed.

关 键 词：支气管动脉 咯血 栓塞 聚乙烯醇 

分 类 号：R56[医药卫生—呼吸系统] R815[医药卫生—内科学]