支气管动脉栓塞术在中央气道恶性肿瘤经内镜介入诊疗中的临床应用价值  

Clinical value of bronchial artery embolization during bronchoscopic interventional treatment in patients with Central airway tumors

作　　者：曾雅玲 王宪刚[2] 李先华[2] 李兴明[2] 谢秀芳[2] 罗进[2] 李云[2] 范贤明 ZENG Yaling;WANG Xiangang;LI Xianhua;LI Xingming;XIE Xiufang;LUO Jin;LI Yun;FAN Xianming(Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Respiratory and Critical Care Medicine,the First People′s Hospital of Neijiang City,Neijiang,Sichuan 641000,China)

机构地区：[1]西南医科大学附属医院呼吸与危重症医学科,四川泸州646000 [2]内江市第一人民医院呼吸与危重症医学科,四川内江641000

出　　处：《临床肺科杂志》2025年第5期672-676,共5页Journal of Clinical Pulmonary Medicine

基　　金：内江市科技计划项目资助(Z202301)。

摘　　要：目的探讨支气管动脉栓塞术(Bronchial artery embolization,BAE)在中央气道肿瘤经内镜介入治疗诊疗中辅助止血、降低手术风险的临床应用价值。方法回顾性分析57例符合入组标准的中央气道肿瘤患者接受内镜介入治疗的临床资料,根据介入治疗前是否行BAE分为两组:A组30例仅行介入治疗,B组27例介入治疗前行BAE;分析介入组患者支气管动脉CTA(BA-CTA)情况,对比介入治疗过程中的两组患者的出血情况。结果两组基线资料对比进行均衡性检验,P值均>0.05,两组均衡可比。A组30例均成功完成支气管镜介入治疗,术中少量出血15例、中量出血13例、大量出血2例。B组27例均成功进行BAE及支气管镜介入治疗,其中少量出血22例、中量出血4例、大量出血1例;B组患者DSA共检出瘤体血管57支,成功栓塞血管56支,其中17例术前完善BA-CTA,共检出瘤体相关血管29支,平均开口径约0.18cm。B组在支气管镜介入治疗过程中的中大量出血率小于A组(P=0.017)。结论中央气道肿瘤患者在行支气管镜介入治疗前进行BAE,能够减少术中出血量,提高介入治疗安全性;术前BA-CTA检查有助于指导BAE。Objective To investigate the clinical application value of Bronchial artery embolization(BAE)in endoscopic interventional treatment of central airway tumors to assist hemostasis and reduce the risk of surgery.Methods The clinical data of 57 patients with central airway tumors who met the enrollment criteria and received endoscopic interventional therapy were retrospectively analyzed,and they were divided into two groups according to whether they received BAE before interventional therapy:30 patients in group A received interventional therapy only,and 27 patients in group B received BAE before interventional therapy.The bronchial artery CTA(BA-CTA)of patients in the interventional group was analyzed,and the bleeding of patients in the two groups during interventional treatment was compared.Results The baseline data of the two groups were compared for the equilibrium test,and the P values were all>0.05,indicating that the balance between the two groups was comparable.Bronchoscopic interventional therapy was completed in all 30 cases in group A,with 15 cases of minor bleeding,13 cases of moderate bleeding,and 2 cases of massive bleeding.BAE and bronchoscopic interventional therapy were successfully performed in all 27 cases in group B,including 22 cases with small bleeding,4 cases with moderate bleeding,and 1 case with massive bleeding.In group B,a total of 57 tumor vessels were detected by DSA,and 56 vessels were successfully embolized.Among them,17 patients underwent preoperative BA-CTA,and a total of 29 tumor-related vessels were detected,with an average opening diameter of 0.18cm.The rate of massive bleeding during bronchoscopic intervention in group B was lower than that in group A(P=0.017).Conclusion BAE treatment before bronchoscopic intervention in patients with central airway tumors can reduce intraoperative blood loss and improve the safety of interventional therapy.Preoperative BA-CTA examination is helpful in guiding BAE.

关 键 词：支气管动脉栓塞术 支气管镜介入治疗 中央气道恶性肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]