摘要
目的 探讨支气管动脉畸形大咯血的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C3 导管选择性插入支气管动脉,高压注入38 % 泛影葡胺,每次总量6~8 ml,0-5 ~1-0 ml/s,行正位DSA,分析支气管动脉畸形的DSA表现,确诊后用对比剂稀释的明胶海绵粉进行栓塞,随访栓塞疗效。结果 (1)DSA表现:6 例患者两侧或单侧支气管动脉主干或( 和)分支示增粗、扩张、扭曲、粗细不均,并可见随出血外溢的对比剂团,1 例患者伴有支气管动脉肺动、静脉瘘。(2)随访:4 例患者分别随访6、3 、2 年及6 个月,未见复发,疗效显著。1 例于栓塞后2 个月又出现咯血,DSA提示栓塞后支气管动脉部分再通,经第2 次栓塞后,随访5 年至今,未见复发亦无并发症发生。1 例有左上支气管动脉肺动、静脉瘘的患者行手术治疗。结论 DSA 是确诊支气管动脉畸形大咯血的首选方法,用明胶海绵粉进行栓塞治疗临床疗效好,并发症少。
Objective To study the manifestations of DSAof bronchial artery andthe clinical effectof embolization- Methods Transfemoral Seldingertechnique was used in all 6 cases using a cobra C3 catheter selectivelyinto bronchialartery- Theamountofcontrast medium injectedrangedfrom 5to8 mlperinjection,ata rateof0-5-1-0 ml/s- Gelfoam powder was used for embolization- Results Theright and(or) left bronchial artery and(or)itsbranchesshowed enlargement,twisting,irregulardiameter,and extravsation ofcontrast medium wasobserved because of bleeding- One case had a left bronchial artery malformation with a artery artery artery venousfistula- 5/6 patients weretreated with BAE,bleeding stopped after BAE- Bleedingrecurredin onepatient after2 month,DSAshow partialrecanalization ofbronchialartery- Afterthesecondembolization,the bleeding was controlled-5/6 patients werefollowed for 6 years,5 years,3 years,2 years,and 6 months respectively,without recurrenceofhemoptysis,theclinicaleffectwasgood- Conclusions DSAisthe methodofchoiceto diagnosisthe malformation ofbronchialartery -Theclinicaleffectof BAEwith gelfoam powderis good withlesscomplications-
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1999年第10期699-701,共3页
Chinese Journal of Radiology
关键词
支气管动脉畸形
DSA
血管道影
栓塞疗法
咯血
Bronchialartery Hemoptysis Angiography,digitalsubtraction Embolization , therapeutic