支气管动脉介入栓塞治疗大咯血疗效观察

目的探讨支气管动脉介入栓塞治疗大咯血的疗效观察。方法选择47例大咯血患者行胸片、CT和DSA(数字减影血管造影)检查,明确病变部位、大小、性质、出血靶血管,采用Seldingers技术经皮穿刺股动脉或者肱动脉插管,用Cobra(眼镜蛇导管)导管直径5 F或者微导管实施靶血管栓塞治疗。结果 47例患者肺部X线平片、CT检查明确病变部位与出血动脉分布区符合,DSA造影显示病变支气管动脉及分支增粗走形迂曲等改变,造影剂外溢。栓塞后造影见末梢血管闭塞,主干近端显影,47例患者咯血停止。术中、术后患者无不适症状,未出现异位栓塞、脊髓损伤并发症。随访3年,无咯血发生。结论靶血管栓塞对咯血治疗效果显著。

Objective To observe the effects of bronchial arterial embolization in massive hemoptysis. Methods 47 patients with massive hemoptysis were treated with chest radiograph , CT scans and DSA（Digital Subtraction Angiography） examination to identify the location ,size quality of the diseased areas and the bleeding blood vessel. Seldinger＇s technology were used to perform percutaneous puncture on femoral artery or brachial artery ,and located vascular embolization therapy were performed with cobra catheter which is 5 F in diameter or microcatheter. Results The locations of diseased areas showed on 35 patients＇ lung X-ray and CT scans were corresponded with the bleeding artery distribution area.DSA showed that diseased bronchial artery and its branches have changes in thickening ,running shapes and twisting, and contrast medium spilled. The radiography showed that peripheral vessels occluded and proximal vessel trunk developed alter embolization, and 47 patients＇ hemoptoe are stopped. Conclusion Located vascular embolization therapy has a great effect on hemoptoe,and the therapy is worth popularizing.