多层螺旋CT支气管动脉成像对咯血患者非支气管性体循环供血动脉介入栓塞的应用价值  

作　　者：戴简吉 金红来[1] 胡晓钢[1] 林开勤[1] 何建荣[1] 

机构地区：[1]浙江省金华市中心医院,321000

出　　处：《浙江临床医学》2020年第11期1660-1661,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨分析多层螺旋CT支气管动脉成像(BA-CTA)对咯血患者非支气管性体循环供血动脉(NBSA)介入栓塞的应用价值。方法收集2019年1月至12月75例因咯血行选择性支气管动脉栓塞术(BAE)患者的资料,所有患者术前均行BA-CTA检查,对其图像进行分析后获得责任血管的数目、开口位置、走形特点等信息,BA-CTA检查后3d内所有患者均进行支气管动脉造影及BAE,并与BA-CTA数据进行对照分析。结果75例患者中,通过对BA-CTA的分析共发现责任血管206支,其中支气管动脉(BA)134支(65.0%),NBSA 72支(35.0%)。数字减影血管造影技术(DSA)发现责任血管共217支,其中BA 137支(63.1%),NBSA 80支(36.9%)。所有责任血管成功进行栓塞后,术后71例活动性出血得到有效控制,咯血治愈率达94.7%;BA-CTA对咯血责任血管诊断准确率达94.9%(206/217).对BA诊断准确率达97.8%(134/137),对NBSA诊断准确率达90.0%(72/80)。结论NBSA在咯血患者的责任血管中占有较高的比例,BA-CTA对NBSA有较高的检出率,对BAE手术的成功有指导性的意义。Objective To explore and analyze the aplicaton value of mulislice computer tomogmphy bronchial angiography(BA-CTA)for interventional embolization of nonbronchial systemic arteries(NBSA)in patients with hemoptysis.Methods The data of 75 patients underwent selective bronchial artery embolization(BAE)due to hemoptysis were cllcted from January 2019 to December 2019 in our hospital.All patients underwent BA-CTA examination before operation,and their images were obtained after analysis.The number of reponsible blood vessels,the location of the opening,the characteristics of the shape of the walk,and other information.All patients underwent bronchial arteriography and bronchial artery embolization(BAE)within 3 days after the BA-CTA examination,and were compared with BA-CTA data.Results Among 75 patients,206 vessels were found to be responsible for the analysis ofBA-CTA,including 134 BA(134/206,65.0%)and 72 NBSA(72/206,35.0%).DSA found a total of 217 responsible blood vessels,including 137 BA(137/217,63.1%)and 80 NBSA(80/217.36.9%).After sccessful embolization of all responsible blood vessels,71 cases of active bleeding were ffctively contolled after operntion,and the cure rate of hemoptysis reached 94.7%;the accuracy rate of BA-CTA for the diagnosis of responsible blood vessels of hemoptysis reached 94.9%(206/217),and the diagnosis of BA The accurncy rate was 97.8%(134/137),and the diagnostic accuracy rate for NBSA was 90.0%(72/80).Conclusion NBSA occupies a higher proportion of responsible blood vessels in patients with hemoptysis.BA-CTA has a higher detection rate of NBSA,which is instructive for the success of BAE surgery.

关 键 词：咯血 责任血管 非支气管性体循环供血动脉 多层螺旋CT支气管动脉成像 支气管动脉栓塞术 

分 类 号：R73[医药卫生—肿瘤]