膈下动脉栓塞治疗大咯血介入栓塞后复发1例并文献复习

The hemoptysis recurrent after inferior phrenic artery embolization: a case report and literature review

目的:探讨以膈下动脉为大咯血责任血管的介入栓塞疗效,提高对非支气管性体动脉在大咯血介入栓塞治疗价值的认识。方法:分析1例右侧膈下动脉参与大咯血的临床、影像学资料及介入栓塞治疗的效果。对可能参与供血的血管均行动脉造影,对参与右肺病变的供血动脉行栓塞治疗。复习文献,分析非支气管性体动脉破裂致咯血介入治疗的价值。结果:患者诊断为支气管动脉扩张伴咯血,行支气管动脉栓塞术后再发咯血。腹腔动脉造影示右侧膈下动脉参与供血,行右侧膈下动脉肺底支栓塞后止血成功。结论:膈下动脉参与供血是介入栓塞治疗后咯血复发的少见原因。对于病变位于下肺咯血的患者,有必要行膈下动脉造影。

Objective： To explore the effects of the endovascular embolization of inferior phrenic artery（ IPA） on the recurrence of hemoptysis for improving the knowledge of IPA in massive hemoptysis. Methods： The clinical and angiographic data and effects of interventional embolization in a patient with massive hemoptysis were retrospectively analyzed. The involved blood vessel were detected by arterial angiography,the right pulmonary artery was treated with embolization. The interventional value in the treatment of haemoptysis caused by non-ruptured bronchial artery. Results： The recurrence of massive hemoptysis in patient with bronchiectasia complicated with hemoptysis were found after bronchial arterial embolism. The celiac arteriography showed that the right IPA supplied blood,the hemostasis was completed after the embolism of the end of the right IPA pulmonary. Conclusions： IPA can rarely cause the recurrence of hemoptysis after embolization. It is necessary to examine phrenic artery angiography in patient with lower lobe lesion.