肺栓塞合并支气管动脉-肺动脉瘘导致咯血的介入治疗

Interventional Treatment of Hemoptysis Associated with Pulmonary Embolism

目的:通过肺动脉、支气管动脉造影分析慢性肺动脉栓塞后咯血的原因,并探讨对其介入治疗的安全性和有效性。材料和方法:CT和导管法肺动脉造影证实的慢性肺栓塞13例,其中伴咯血7例(男性1例,女性6例)。对咯血者进行支气管动脉造影后行支气管动脉栓塞治疗。结果:7例肺栓塞伴咯血者的支气管动脉造影均发现支气管动脉-肺动脉瘘,行支气管动脉栓塞术后咯血消失,短期随访生活质量明显改善。结论:支气管动脉-肺动脉瘘是慢性肺动脉栓塞后咯血的主要原因,行支气管动脉栓塞治疗可有效地控制咯血,并且对肺的血供无明显不良影响。

Purpose： To analyze the causes of hemoptysis associated with PE by pulmonary and bronchial angiography. To discuss the possibility and safety of the interventional treatment of hemoptysis. Materials and Methods： 13 cases of PE identified by CTPA and pulmonary angiography, 7 cases, 1 male and 6 femals, with hemoptysis. Bronchial artery angiogranphy and embolization were performed. Results： The most important cause of hemoptysis identified by bronchial angiography is pulmono - bronchial shunt in PE patients. Bronchial artery embolization can provide effective control of hemorrhage in all patients of this group. Life qualities of the patients were improved. Conclusion： The main cause of hemoptysis in chronic PE patients is pulmono - bronchial shunt. Bronchial arteryembolization could control the hemoptysis effectively, but has no effect on blood supply of lung.