多支血管栓塞在介入栓塞治疗大咯血中的应用

Clinical applicability value of multiple blood endovascular embolization in the therapy of massive hemoptysis

目的探讨对多支血管参与供血的咯血患者行介入栓塞治疗的方法、意义。方法急性咯血病例44例,在完成支气管动脉造影后,逐一对肋间动脉、胸廓内动脉等体循环动脉进行造影检查,发现18例有2支以上血管参与供血,对异常血管用明胶海绵或聚乙烯醇微粒栓塞。结果 18例中共有56支血管参与供血,其中支气管动脉27支、肋间动脉24支、胸廓内动脉3支、左膈下动脉1支、甲状颈干1支。16例经一次栓塞治疗后即刻止血,2例1周内再次出血,经再次栓塞后成功止血。结论在肺咯血栓塞治疗中,重视寻找支气管动脉之外的其他参与供血的体循环动脉,对提高止血成功率、减少复发有重要意义,同时栓塞多支体循环动脉是安全的。

Objective To study the method and significance of interventional embolization therapy of the patients of multiple blood supplies of hemoptysis. Methods In 44 patients with hemoptysis who underwent bronchial artery embolization, 18 were cases found that their blood supply were from more than 2 non-bronchial systemic arteries. Embolic materials included absorbable gelatin sponge or polyvinyl alcohol. Results In the 18 cases with 56 non-bronchial systemic arteries 27 were bronchial arteries, 24 intercostal arteries, 3 internal thoracic arteries, 1 left inferior phrenic, 1 thyrocervical trunk. 16 cases were performed embolization once, 2 cases performed twice. Conclusion During bronchial artery embolization for hemoptysis patients, all supplying arteries both bronchial and non-bronchial systemic artery should be searched and found. It can increase the success rate and decrease the recurrence rate of hemostasis, and it is a safer way of embolization of non-bronchial, systemic artery.