支气管动脉CTA在大咯血介入栓塞治疗中的应用

Utilization of bronchial artery CT angiography in embotherapy for massive hemoptysis

目的探讨支气管动脉CTA在大咯血介入栓塞治疗中应用的策略及临床效果。方法 80例大咯血的患者在介入栓塞治疗前行支气管动脉CT血管造影(CTA)检查,在介入手术中寻找所有的出血动脉,并逐一进行栓塞治疗。68例患者栓塞治疗1周后复查支气管动脉CTA检查。对支气管动脉CTA在大咯血介入栓塞治疗中的应用效果进行回顾性总结评价。结果 80例大咯血的患者在介入栓塞治疗前行支气管动脉CTA检查,共找到107支病变的出血动脉,介入手术中共找到118支出血动脉并成功栓塞治疗。术前支气管动脉CTA检查诊断的准确率为90.68%(107/118)。68例患者栓塞后治疗支气管动脉CTA检查显示所有已栓塞的支气管动脉栓塞效果良好。结论介入栓塞治疗前支气管动脉CTA检查可以为支气管动脉栓塞治疗中寻找出血动脉提供准确的定位作用。栓塞治疗后行支气管动脉CTA检查有利于对栓塞疗效的准确判定。

Objective To explore the strategy and clinical effect of bronchial artery CT angiography in embolotherapy for massive hemoptysis. Methods Eighty patients of massive hemoptysis underwent bronchial artery CT angiography before embolotherapy. All bleeding arteries were found and blocked one by one in embolotherapy. Bronchial artery CT angiogra phy was conducted after a week of embolotherapy in 68 patients. The strategy and clinical effect of bronchial artery CT an giography in embolotherapy for massive hemoptysis was analysed retrospectively. Results All 107 bleeding arteries were found in eighty patients underwent bronchial artery CT angiography before embolotherapy. While, 118 bleeding arteries were located and embolized successfully in embolotherapy. Diagnostic accuracy of bronchial artery CT angiography before embolotherapy was 90. 68% （107/118）. Bronchial artery CT angiography after embolotherapy confirmed the embolized bleeding arteries were blocked completely in 68 patients. Conclusion Bronchial artery CT angiography before embolother apy can provide the effect of location for finding the bleeding arteries in embolotherapy. Bronchial artery CT angiography after embotherapy is conducive to determine the efficacy of embolization.