靶血管超选择性栓塞治疗难治性大咯血的临床应用  

Clinical Application of Super Selective Embolization of Target Blood Vessels in Treatment of Refractory Massive Hemoptysis

作　　者：童玉云[1] 赵金友[1] 王家平[1] 李迎春[1] 姜华[1] 李松蔚[1] 王雪刚[1] 

机构地区：[1]昆明医科大学第二附属医院,云南昆明650101

出　　处：《昆明医科大学学报》2015年第7期126-130,共5页Journal of Kunming Medical University

摘　　要：目的评价难治性大咯血靶血管超选择栓塞术的方法、细节和疗效,以提高超选择插管治疗大咯血的成功率.方法搜集昆明医科大学第二附属医院2000年3月至2013年12月介入治疗难治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87例,行靶血管超选择病灶栓塞术.栓塞材料为明胶海绵颗粒、钢圈、PVA颗粒等.结果 87例难治性大咯血中82例完成18月随访,5例未完成随访.总体治愈65例,治愈率74.71%,显效10例,有效4例,无效3例,总体有效率90.8%.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43例,复杂供血44例.结论超选择性靶血管栓塞是介入治疗大咯血科学有效、安全、不可替代的治疗方法,而且疗效好、创伤小,并发症发生率低,可成为临床首选的微创治疗方法.Objective To retrospectively evaluate the method, details and curative effect for superselective embolization of the refractory massive haemoptysis, so as to improve the success of the super selective intubation. Methods We collected 87 refractory massive haemoptysis cases of interventional treatment, which was generated by not typical bronchial arterial and repeated attacks of haemoptysis during May 2000 and December 2013. All of them were given superselective embolization of vascular lesions. Embolism materials included gelfoam sponge （GS） granules or coils or polyvinyl alcohol （PVA） granules etc. Results Among 87 cases of refractory massive haemoptysis, 82 cases were followed up for 18 months, 65 cases were cured, the cure rate was 74.7%, 10 cases were significantly effective, 4 cases were basically effective, and 3 cases were not effective, the total cure rate was 90.8%. And we found that except bronchial arterial, otherwise a variety of arterials participated in lesions. Among them simple abnormal arterial was found in 43 cases, and complex blood-supply was found in 44 cases. Conclu- sion Super selective target vascular embolization is a safet, effective and irreplaceable treatment with good effect, minimal invasion and low complication rates. It has become the preferred clinical minimally invasive treatment.

关 键 词：难治性大咯血 超选择插管 介入治疗 靶血管栓塞 

分 类 号：R562.2[医药卫生—呼吸系统]