超选择性靶血管栓塞术治疗难治性大咯血的体会  

The Experience of Superselective Target-Vessel Embolization in Curing Intractable and Massive Haemoptysis

作　　者：童玉云[1] 王家平[1] 侯凯[1] 李迎春[1] 杨青[1] 姜华[1] 罗剑渊[1] 李松蔚[1] 

机构地区：[1]昆明医学院第二附属医院放射科,650101

出　　处：《临床放射学杂志》2012年第2期265-268,共4页Journal of Clinical Radiology

摘　　要：目的回顾性评价难治性大咯血超选择靶血管栓塞术的方法和疗效,提高超选择插管治疗大咯血的成功率。资料与方法搜集我院1998年5月至2011年3月介入治疗大咯血病例中非典型支气管动脉供血、反复发作的难治性大咯血患者67例,行超选择病灶血管栓塞术。栓塞材料为明胶海绵颗粒、钢圈、聚乙烯醇(PVA)颗粒、Fe3O4微粒等。结果 67例难治性咯血患者中62例完成18个月随访,总体治愈53例,显效12例,基本有效2例,无效0例。发现除支气管动脉外,另有多种血管参与供血,其中单纯异常血管供血33例,复杂供血34例。结论超选择病灶血管栓塞不仅是介入治疗大咯血科学、有效、安全、不可替代的方法,而且还能够发现更多的解剖变异。超选择插管与否以及插管成功之后治疗细节的把握,对难治性大咯血的治疗有重要意义。Objective To evaluate the curative effect of superselective embolization in the intractable and massive haemoptysis,and to improve the treatment of super selective intubation.Materials and Methods Sixty seven cases of massive haemoptysis,atypical bronchial arterial supply and repeated attack of haemoptysis underwent superselective vascular embolization during May 1998 and 2011 March.Embolism materials included gelfoam sponge（GS） granules,coils,polyvinyl alcohol（PVA）granules,Fe3O4 particle etc.Results Among 67 cases of haemoptysis,62 cases underwent 18 months follow up.The overall cure in 53 cases,significant mend in 12 cases,basic mend in 2 cases,No invalid occurred.Except of bronchial arterial,a variety of vascular participate in lesions.Among them simple abnormal vascular was found in 33 cases,complex blood supply in 34 cases.Conclusion Superselective vascular embolization is an effective,safe and irreplaceable treatment for massive haemoptysis.Otherwise,selective intubation can find anatomical variations associated with haemoptysis.

关 键 词：难治性大咯血 超选择插管 介入治疗 栓塞剂 

分 类 号：R56[医药卫生—呼吸系统]