经导管超选择性动脉栓塞治疗咯血145例临床分析

发布时间：2018-06-23 20:41

本文选题：咯血 + 超选择性　；参考：《临床放射学杂志》2014年05期

【摘要】：目的回顾性分析超选择性栓塞支气管动脉(BA)和/或非支气管性体动脉(NBSA)在治疗咯血中的方法与疗效。方法 145例经内科药物治疗未能控制的咯血患者,行系统的动脉造影,根据造影情况超选择性BA和/或NBSA插管,采用栓塞剂(明胶海绵、PVA颗粒、微弹簧钢圈等)行1~2次栓塞治疗,其中77.2%(112/145)行双重栓塞。术后随访观察临床疗效和并发症。随访时间3~46个月。结果造影阳性率97.9%(142/145),142例中69例(48.6%)发现与咯血相关的NBSA 163支,包括有肋间后动脉76支、锁骨下及腋动脉的分支63支、膈下动脉13支、食管固有动脉9支、胃左动脉2支。咯血控制率91%(132/145),中远期复发率12.9%(17/132)。术后1例出现肺功能衰竭。结论系统的血管造影是发现咯血责任血管的重要方法,超选择性动脉栓塞术可有效控制咯血,双重栓塞、有效的原发病治疗有助于提高手术的远期疗效。
[Abstract]:Objective to retrospectively analyze the treatment of hemoptysis by superselective embolization of bronchial artery (BA) and / or non bronchial artery (NBSA). Methods 145 patients with hemoptysis who could not be controlled by internal medicine were treated with systemic arteriography. According to the angiographic conditions, superselective BA and / or NBSA catheterization were performed, and embolization agent (gelatin sponge PVA granules) was used. Among them, 77.2% (112 / 145) received double embolization. The clinical effect and complications were observed after operation. The follow-up time was 3 ~ 46 months. Results the positive rate of angiography was 97.9% (142 / 145) in 142 cases (48.6%), including 76 branches of posterior intercostal artery, 63 branches of subclavian and axillary artery, 13 inferior phrenic artery, 9 esophageal proper artery and 2 left gastric artery. The hemoptysis control rate was 91% (132 / 145) and the mid-and long-term recurrence rate was 12. 9% (17 / 132). Postoperative pulmonary failure occurred in 1 case. Conclusion systemic angiography is an important method to find blood vessels responsible for hemoptysis. Superselective arterial embolization can effectively control hemoptysis, double embolization and effective treatment of primary diseases.
【作者单位】：广东省中山大学附属梅州医院介入科;
【分类号】：R56;R816.4

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