摘要
目的探讨外科肺叶切除术前,对合并胸膜增厚粘连的病例进行超选择性体循环供血动脉栓塞术,减少术中出血量的效果和临床价值。方法回顾胸腔镜下肺叶切除的连续病例164例,其中筛选出CTA及手术证实术区胸膜广泛粘连的单侧肺叶切除患者43例。按外科术前是否接受过栓塞术将筛选出的病例分为A组(24例)和B组(19例)。分析两组患者的临床和影像资料、动脉栓塞术记录、外科手术记录,比较两组病例肺叶切除术中的出血量。结果A、B两组于术前胸部CT均见病变肺叶区多发胸膜增厚、粘连(后胸壁为著),与外科术中所见术区胸腔胸膜广泛粘连相符,检出胸膜增厚相关的异常体动脉A组108支、B组82支,两组差异无显著性;肺叶切除术中出血量中位数A组为400 ml、B组为1200 ml,A组出血量较B组明显减少,两组差异有显著性(P<0.05)。结论伴有显著胸膜增厚的肺部病变,行肺叶切除术前进行超选择胸膜增厚相关体动脉栓塞术可有效减少术中出血量。
Objective To investigate the value of preoperative super-selective systemic arterial embolization for reducing blood loss during pulmonary lobotomy in patients with pleural adhesions.Methods Of 164 consecutive thoracoscopic lobectomies,43 patients undergoing unilateral lobectomies for extensive pleural adhesions confirmed by CT and surgery were divided into group A with(24)or group B without(19)preoperative embolization.The clinical and imaging data,arterial embolization and surgical records were analyzed to compare the amount of blood loss during lobectomy between the two groups.Results There was no significant difference(P>0.05)in the association of abnormal systemic arteries with pleural thickening and adhesions between group A(108)and group B(82).The median amount of blood loss during lobectomy was significantly(P<0.05)less in group A(400 ml)than group B(1200 ml).Conclusion Preoperative super-selective systemic arterial embolization can effectively reduce blood loss during pulmonary lobotomy in patients with pleural adhesions.
作者
冯俊翔
伍筱梅
戴立果
叶永胜
刘彩银
FENG Jun-xiang;WU Xiao-mei;DAI Li-guo;YE Yong-sheng;LIU Cai-yin(Department of Radiology,The First Affiliated Hospital of Guangzhou Medical University,Guangdong 510120,China)
出处
《影像诊断与介入放射学》
2021年第2期124-129,共6页
Diagnostic Imaging & Interventional Radiology
关键词
胸膜增厚
肺叶切除术
出血
动脉栓塞术
Pleural thickening
Lobectomy
Bleeding
Arterial embolization
