支气管动脉-肺动脉瘘致大咯血的介入治疗

Interventional treatment of the massive hemoptysis caused by the bronchial-pulmonary artery fistula

目的观察支气管动脉-肺动脉瘘的血管造影表现,评价介入治疗支气管动脉-肺动脉瘘致咯血的重要性、安全性以及疗效。方法2007年1月-2008年1月我院共收治大咯血患者39例,其中12例存在支气管动脉-肺动脉瘘,均行支气管动脉栓塞术(BAE)治疗,分析支气管动脉-肺动脉瘘致咯血的表现、病理解剖学特点,评价BAE治疗支气管动脉-肺动脉瘘的安全性和疗效。结果本组12例支气管动脉-肺动脉瘘致咯血患者,均用明胶海绵颗粒行BAE治疗,术后止血率为100%,无明显并发症出现,平均随访13.5个月(6～18个月),患者均未发生再次咯血。结论支气管动脉-肺动脉瘘是咯血的病理解剖结构,BAE是治疗和预防此类咯血的有效措施。

Objective To observe the DSA manifestations of the bronch - pulmonary arterial fistula, appraise the importance, safety as well as the curative effect of the interventional treatment. Methods From January 2007 to January 2008, 39 patients with massive hemoptysis including 12 broncho - pulmonary arterial fistulas were treated by BAE. Analysis of the manifestations and characteristics of pathologic anatomy of the hemoptysis of the broncho - pulmonary arterial fistula were performed; and furthermore the importance and clinical significance of the BAE were appraised. Results All 12 patients with massive hemoptysis due to the bronchial-pulmonary artery fistula underwent BAE using gelatin sponge. The rate of immediate hematischesis was 100%, with out any complications. The patients were followed-up of 13.5 months(ranged from 6 to 18 months) and no recurrence was found. Conclusion Bronchial-pulmonary artery fistula is one of the pathologico-anatomic structures of the hemoptysis. BAE is the effective management and prevention for this kind of hemoptysis with safety and efficacy.