非支气管动脉与支气管动脉联合双重栓塞治疗大咯血  

Combined and double bronchial-nonbronchial arterial embolization for treating heavy hemoptysis

作　　者：付渡关[1] 赵大兵[1] 李晖[1] 曹平[1] 宋萍[1] 

机构地区：[1]湖北医药学院附属襄阳医院介入科,湖北襄阳441000

出　　处：《医学影像学杂志》2012年第11期1873-1875,共3页Journal of Medical Imaging

摘　　要：目的探讨非支气管动脉与支气管动脉联合双重栓塞治疗大咯血的临床应用价值。方法 21例急性大咯血患者,行支气管动脉与非支气管动脉(包括肋间动脉、胸廓内动脉、胸上动脉、肩胛下动脉、隔动脉等)造影,并对异常血管用PVA颗粒、明胶海绵和/或钢圈双重栓塞。结果 21例大咯血患者,共栓塞74支异常血管。其中支气管动脉32支,肋间动脉22支、胸廓内动脉9支,胸上动脉6支,膈动脉3支、肩胛下动脉2支。术后即刻止血14例,咳血量明显减少5例,有所减少2例,即刻止血率及总有效率分别为71.4%、100%。无严重并发症发生。结论在行支气管动脉栓塞治疗咯血时,同时仔细寻找并栓塞参与供血的非支气管动脉有重要的临床意义,能提高疗效,降低复发。Objective To evaluate the clinical value of combined and double bronchial-nonbronchial arterial embolization for treating heavy hemoptysis. Methods After the selective arteriography, bronchial-nonbronchial including arterial em- bolization with polyvinyl alcohol （PVA） particles, gelatin sponge and/or coil, was performed in 21 patients with heavy he- moptysis. Results In 19 patients, 58 responsible arteries were embolized. CBIAE was performed in 17 patients, and only bronchial arterial embolization was performed in 1 patient and only intercostal arterial embolization in another patient. Bleeding stopped within 24 hours in 16 patients of the 17 patients treatedwith CBI-AE （94.18%） and bleeding stopped within one week in another patient. The total effective rate of CBIAE was 100% （17/17）. Only bronchial oronly intercos- tal arterial embolization was ineffective in 2 Patients. Recurrence of hemoptysis was found in 2 patients in 3 to 6 months. No serious complication related to embolization occurred. Conclusion CBIAE is a fast, safe and effective way lot treating heavy hemoptysis from pulmonary tuberculosis.

关 键 词：支气管动脉 肋间动脉 胸廓内动脉 胸上动脉 肩胛下动脉 隔动脉 咯血 栓塞 

分 类 号：R521[医药卫生—内科学] R815[医药卫生—临床医学]