支气管动脉栓塞术中Cobra联合Yashiro导管对栓塞成功率的影响  

Success rate of Cobra combined with Yashiro catheter bronchial artery embolization

作　　者：余龙伍[1] 华双一[1] 严雄[1] 吴扬 YU Long-wu;HUA Shuang-yi;YAN Xiong;WU Yang(Department of Intervention,the PLA Navy Anqing Hospital,Anhui 246000,China)

机构地区：[1]中国人民解放军海军安庆医院介入科,安徽安庆246000

出　　处：《影像诊断与介入放射学》2020年第3期195-200,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的观察支气管动脉栓塞术中Cobra联合Yashiro导管的栓塞成功率,并随访其疗效。方法回顾性分析,采集我院2015年1月~2017年1月期间支气管动脉栓塞术中单纯使用Cobra导管的70例患者纳入单一导管组(单一组),另选取2017年2月~2019年12月期间将支气管动脉栓塞术中联合使用Cobra与Yashiro导管的56例患者纳入联合导管组(联合组)。所有患者均完成为期3年的有效随访,记录两组患者动脉造影影像学特征、责任血管检出情况,对比两组手术及恢复相关指标,随访3个月~3年,记录并对比两组支气管栓塞的效果及并发症发生率及术后3个月内咯血复发率。结果126例患者均接受支气管动脉栓塞术治疗。联合组共检出207支责任支气管动脉,其中Cobra导管检出133支,Yashiro导管检出74支;随访结束后,联合组栓塞总有效率较单一组高,联合组手术时间较长,但X线透视时间及住院时间较短,差异有统计学意义(P<0.05);两组并发症发生率对比,差异无统计学意义(P>0.05);随访3个月期间,观察组咯血再复发率低于对照组,差异有统计学意义(P<0.05)。结论Cobra联合Yashiro导管显著提高支气管栓塞动脉检出率,针对内科保守治疗无效且外科手术指征不明显的患者,支气管动脉栓塞术中采取Cobra联合Yashiro导管可降低因支气管动脉CT血管造影漏检导致再发咯血风险,提高支气管动脉栓塞成功率,虽手术时间略长但整体获益较高。Objective To observe the success rate of Cobra combined with Yashiro catheters in bronchial artery embolization(BAE).Methods 70 patients who underwent Cobra catheter BAE from January 2015 to January 2017 and 56 patients who underwent BAE with Cobra and Yashiro catheters from February 2017 to December 2019 were included in this retrospective study.The imaging characteristics and detection of responsible blood vessels on arteriography,procedure-and recovery-related indicators,effect of BAE,incidence of complications,rate of recurrent hemoptysis within 3 months after BAE were compared.Results In 56 patients with combined Cobra and Yashiro catheter BAE,207 responsible bronchial arteries were detected,including 133 with Cobra catheters and 74 with Yashiro catheters.The total effective rate of embolization was higher and the procedure time was longer,whereas the fluoroscopy and hospitalization time was shorter in the combined catheter group than that in the single catheter group.The difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).At the 3-month follow-up,the rate of recurrent hemoptysis was significantly lower in the combined than that in the single catheter group(P<0.05).Conclusion Cobra combined with Yashiro catheter arteriography can significantly improve the detection of bronchial arteries and increase the success rate of BAE.The risk of recurrent hemoptysis caused by missed detection of bronchial artery on CT angiography is reduced even though the procedure time is slightly longer.

关 键 词：支气管动脉栓塞术 Cobra导管 Yashiro导管 成功率 并发症 

分 类 号：R655.3[医药卫生—外科学]