肺动静脉畸形破裂相关性咯血的急诊相关治疗  

Transvascular embolisation for management of hemoptysis associated with ruptured pulmonary arteriovenous malformation

作　　者：丁菊蓉 王珊梅[1] 沈莉[1] 谈炎霖 王晶晶[1] 虞栋[2] 马旭 姜洪斌[1] DING Ju-rong;WANG Shan-mei;SHEN Li;TAN Yan-lin;WANG Jing-jing;YU Dong;MA Xu;JIANG Hong-bin(Dept.of Emergency,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433,China;Dept.of Radiology,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433,China)

机构地区：[1]同济大学附属上海市肺科医院急诊科,上海200433 [2]同济大学附属上海市肺科医院放射科,上海200433

出　　处：《同济大学学报（医学版）》2020年第4期497-501,共5页Journal of Tongji University(Medical Science)

摘　　要：目的探讨介入栓塞术对肺动静脉畸形(pulmonary arteriovenous malformation,PAVM)破裂导致咯血患者的急诊治疗的疗效。方法回顾性收集2016年9月—2019年12月内出现PAVM破裂相关性咯血且接受介入栓塞治疗的患者资料,并进行统计分析,所有研究对象术前均接受影像学检查证实PAVM存在,术后均按计划通过CT检查随访复查。结果8例患者中共13处PAVM接受了介入栓塞治疗,栓塞成功率100%,围手术期无并发症发生。治疗前后的肺功能明显改善,出血症状迅速得到控制(P<0.05)。随访(14.63±10.06)个月内无PAVM复发。结论对于PAVM破裂相关性咯血,介入栓塞治疗安全有效,应为首选治疗手段。Objective To assess the efficacy of emergent transvascular embolisation for the management of ruptured pulmonary arteriovenous malformation(PAVM).Methods From September 2016 to December 2019,patients with ruptured PAVM-induced hemoptysis received interventional embolization.Preoperative CTA was performed in all patients to make a definite diagnosis of PAVM,and patients were followed up with CT examination.Results In 8 patients total 13 PAVM lesions received transvascular embolization.The technical success of embolization was achieved in all cases and no severe complications occurred.The bleeding was promptly controlled and pulmonary function was significantly improved after the treatment(P<0.05).There was no recurrence of PAVM during the follow-up of 14.63±10.06 months.Conclusion Transvascular embolisation is safe and effective for management of hemoptysis associated with ruptured PAVM.

关 键 词：肺动静脉畸形 遗传性出血性毛细血管扩张症 咯血 介入栓塞术 

分 类 号：R459.7[医药卫生—急诊医学]