摘要
目的探讨非支气管性体动脉(NBSA)参与供血的大咯血患者的动脉造影表现及急诊栓塞治疗的疗效。方法回顾性分析36例NBSA参与供血的大咯血患者的临床资料。选用明胶海绵条、聚乙烯醇(poly vinyl alcohol,PVA)颗粒及弹簧圈选择性栓塞出血的动脉,对动脉造影的表现及治疗结果进行总结及评价。结果选择性非支气管性体动脉造影显示出血动脉增粗,分支增多、紊乱及新生血管形成。本组中,对比剂外溢有24例,NBSA与支气管动脉分流6例,对比剂外溢合并甲状颈干-支气管动脉分流2例,NBSA与肺动脉分流3例,假性动脉瘤1例。共栓塞42支NBSA,同时支气管动脉12支,栓塞术后48h内咯血停止。术后随访1年,所有患者无再次咯血及严重的并发症。结论 NBSA可以参与大咯血的供血,漏栓NBSA是大咯血治疗失败和复发咯血的原因之一,急诊NBSA栓塞是一种安全、有效的治疗手段。
Objective To discribe various arteriographic manifestations and to evaluate the efficacy of emergency emboli zation of massive hemoptysis supplied by nonbronchial systemic arteries （NBSA）. Methods The clinical data of 36 pa tients of massive hemoptysis supplied by NBSA were retrospectively analyzed. Emergency arteriography was performed for all patients of massive hemoptysis. The bleeding arteries were embolized by using embolic agents such as gelatin sponge, polyvinyl alcohol （poly vinyl alcohol, PVA） particles and coils. The arteriographic manifestations and effect of the treat ment for massive hemoptysis were analyzed. Results Selective arteriography of NBSA demonstrated enlarged bleeding ar teries, numerous and disorder branches and hypervascularity. The contrast extravasations were found in 24 cases and NB SAto bronchial artery shunts in 6. The contrast extravasations and thyrocervical trunktobronchial artery shunts were found in 2, NBSAtopulmonary artery shunts in 3, and pseudoaneurysm in 1 ; All 42 NBSA and 12 bronchial arteries were embolized. All hernoptysis ceased after 48 hours of embolotherapy. No recurrent hemoptysis and severe complications oc curred after 1year followup in 36 patients. Conclusion NBSA can participate the supply of massive hemoptysis, and o mission of NBSA is one of the reasons for failure of hemostasis or recurrent massive hemoptysis. Emergency arterial embo lization of NBSA for hemoptysis is a safe and effective treatment.
出处
《医学影像学杂志》
2014年第1期36-39,共4页
Journal of Medical Imaging
关键词
非支气管性体动脉
咯血
血管造影
栓塞
N onbronchial systemic artery
Hemoptysis
Angiography
Embolization
