支气管动脉栓塞术治疗肺咯血  

Bronchial artery embolization to control pulmonary hemoptysis

作　　者：马骏[1] 江森[1] 支文祥[1] 尤正千[1] 

机构地区：[1]上海市肺科医院影像科,200433

出　　处：《上海医学影像》2004年第1期21-24,共4页Shanghai Medical Imaging

摘　　要：目的 探讨支气管动脉栓塞术治疗肺咯血的临床价值。方法 45例咯血患者(支气管扩张15例、结核23例、肺癌4例、肺(?)菌病1例、原因不明咯血2例)行选择性支气管动脉或肋间动脉插管造影确认病变血供,然后对病变血管进行栓塞。支气管动脉栓塞37例,肋间动脉栓塞5例,支气管动脉与肋间动脉一同栓塞2例,支气管动脉、肋间动脉及胸廓内动脉一同栓塞1例,20例使用同轴微导管进行超选择性栓塞。明胶海绵栓塞17例,PVA栓塞23例,联合使用明胶海绵及PVA栓塞5例。全部病例随访疗效6-18月。结果 即刻止血30例,咯血明显减少7例,8例再次咯血,其中4例复发患者行再次栓塞后未出现咯血,有效率83％(37/45)。全部病例均无严重并发症(如脊髓损伤)发生。结论 支气管栓塞术治疗肺咯血疗效明显,适用于内科治疗无效及无外科手术适应症的大咯血患者。Objective To investitage the value of bronchial artery embolization in the managent of hemoptysis. Methods 45 patients including bronchiectasis (15eases), tuberculosis (23cases), pulmonary carcinoma (4cases), aspergillosis (1 case), unknown hemoptysis (2case) underwent bronchial arteriography or intercostal arteriography and embolized the abnormal vessels. Bronchial artery embolization were 37 cases, intercostal artery embolization were 2 cases, bronchial artery and intercostal artery combine embolization were 5 cases, bronchial artery、intercostal artery and internal thoracic artery combine embolization were 1 case, 20 cases underwent superselective embolization with coaxial microcather. 17 cases embolized with gehine foam, 23 cases embolized with PVA, 5 cases embolized with geltine foam and PVA. All patients were followed 6-18months. Results Immediate arrest of hemoptysis were 30 cases, marked reduce bleeding were 7 cases, repeated hemoptysis were 8 cases and re-embolization had to be carried out in 4 cases, hemoptysis did not occured. Effect rate was 83%(37/45). Severity complication(spinal coard injury) did not occure in all the patient. Conclusion The effect of selective bronchial artery embolization is evidentand and adapted to massive hemoptysis patients failure to medicine treatment or non-surgery adaptation

关 键 词：支气管动脉栓塞术 治疗 肺咯血 并发症 预防 

分 类 号：R655.3[医药卫生—外科学] R441.7[医药卫生—临床医学]