咯血的造影表现及栓塞治疗  

The Angiographic Manifestations Embolization Therapy of Hemoptysis

作　　者：王家平[1] 袁曙光[1] 闫东[1] 罗罡[1] 李迎春[1] 普成荣[1] 韩正林[1] 

机构地区：[1]昆明医学院第二附属医院放射科DSA室,云南昆明650101

出　　处：《实用放射学杂志》2003年第7期635-637,共3页Journal of Practical Radiology

摘　　要：目的　探讨肺部疾病所致大咯血的DSA表现 ,观察栓塞治疗的疗效。方法　采用Seldinger技术行股动脉穿刺插管 ,将导管插入动脉 ,注入Omnipaque 6～ 9ml,1～ 2ml/s ,分析 84例病人出血动脉的表现。确诊后用对比剂稀释的明胶海绵颗粒 (4 0例 )或永久栓塞 (4 4例 )进行栓塞治疗 ,62例随访 6～ 2 3 .5月。结果　 40例患者单纯用明胶海绵复发率 48% ,用永久栓塞治疗 ,复发 1例 ,复发率为 1.2 % ,栓塞材料永久栓塞剂优于单纯用明胶海绵。结论　超选择性支气管动脉栓塞是急性大咯血的有价值的治疗方法 ,尤其是当患者缺乏手术指征而药物不能有效控制大咯血时 。Objective To study the angiographic findings of massive hemoptysis by lung diseases, and to observe the clinical effect of embolization. Methods Transfemoral Seldinger technique was used in 84 cases using 5F mikleason catheter selectively into bronchial artery,the amount of comtrast omnipaque injected ranged from 6 to 9 ml per injection at a rate of 1～2 ml/s. Gefoam(40 cases) and steel coil or Fe 3O 4 (44 cases) was used for embolization bronchial artery.62 patients were followed up for 6～27.5months.Results In using gefoam for group the recurrent rate was 22%, while the recurrent rate in permanent embolization group was 1.2%. Conclusion The bronchial arterial embolization is an effective method in treating acute hemoptysis , particularly when drug therapy fails and surgical indieation is inadequate.

关 键 词：咯血 影像学检查 超选择性支气管动脉栓塞 肺部疾病 SELDINGER技术 

分 类 号：R441.6[医药卫生—诊断学] R815[医药卫生—临床医学]