支气管动脉CTA对支气管扩张顽固性咯血患者术前应用价值分析  

Preoperative application value of bronchial artery CTA in patients with intractable hemoptysis and bronchiectasis

作　　者：彭保铭 庞一雄[2] 李雄[2] PENG Bao-ming;PANG Yi-xiong;LI Xiong(Postgraduate Training Base of Jinzhou Medical University(Xiaogan Central Hospital),Xiaogan,Hubei 432000,China;Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan,Hubei 432000,China)

机构地区：[1]锦州医科大学研究生培养基地(孝感市中心医院),湖北孝感432000 [2]武汉科技大学附属孝感医院,湖北孝感432000

出　　处：《临床肺科杂志》2023年第2期216-220,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨支气管动脉CTA(血管造影)对支气管扩张顽固性咯血手术患者术前应用价值分析。方法回顾我院2011年1月至2021年9月的84例支气管扩张顽固性咯血行肺切除术患者的临床资料。术前均行支气管动脉CTA检查,根据支气管动脉CTA检查结果阳性和阴性分组来探讨单纯手术组和联合组(支气管动脉栓塞术(BAE)联合手术)在围手术期的安全性,统计两者术中出血量、手术操作时间、术后3天引流、手术方式及术后住院天数有无差异性来反映。结果术前CTA为阴性的情况下,单纯手术组在术后住院天数优于联合组[(7.1±3.7)天vs(9.7±2.5)天,P<0.05],在术中出血量、手术操作时间、手术方式及术后3天引流量两者并无统计学差异;术前CTA为阳性的情况下,联合组在术中出血量、手术操作时间、手术方式、术后住院天数及术后3天引流量优于单纯手术组(P<0.05)。结论支气管动脉CTA阴性的支扩顽固性咯血患者可行单纯的手术治疗;支气管动脉CTA阳性患者行BAE联合手术的围手术期安全性更高,BAE后更有助于行胸腔镜微创手术,术前支气管动脉CTA对明确责任血管以及手术方式有一定的指导意义。Objective To investigate the preoperative application value of bronchial artery CTA(angiography)in patients with intractable hemoptysis and bronchiectasis.Methods The clinical data of 84 patients with intractable hemoptysis and bronchiectasis who underwent pneumonectomy in our hospital from January 2011 to September 2021 were retrospectively analyzed.Preoperative bronchial artery CTA examination was performed on all patients,and the perioperative safety of the simple surgery group and the combined bronchial artery embolization(BAE combined surgery)was discussed according to the positive and negative results of bronchial artery CTA examination.The amount of intraoperative blood loss,operation time,postoperative drainage 3 days,operation method and postoperative hospital stay were counted to reflect the difference.Results In the case of negative preoperative CTA,the duration of postoperative hospital stay in the surgery group was better than that in the combined group[(7.1±3.7)d vs(9.7±2.5)d,P<0.05],and there was no significant difference in intraoperative blood loss,operation time,operation method and 3-day postoperative drainage between the two groups.In the case of positive preoperative CTA,the combined group was superior to the operation group in terms of intraoperative blood loss,operation time,operation method,duration of hospital stay,and 3-day postoperative drainage(P<0.05).Conclusion Patients with intractable hemoptysis and bronchial artery with negative CTA can be treated by simple surgery.The perioperative safety of patients with positive bronchial artery CTA combined with BAE surgery is higher,and it is more conducive to thoracoscopic minimally invasive surgery after BAE.Preoperative bronchial artery CTA has certain guiding significance for defining responsible vessels and surgical methods.

关 键 词：支气管动脉血管造影 支气管扩张 顽固性咯血 肺切除术 

分 类 号：R655.3[医药卫生—外科学]