[1]池嘉昌,许建荣,沈加林,等. 选择性支气管动脉栓塞术控制匿源性咯血[J].介入放射学杂志,2012,(01):27-30.
　CHI Jia-chang,XU Jian-rong,SHEN Jia-lin,et al.Selective bronchial artery embolization for the treatment of cryptogenic hemoptysis[J].J Intervent Med,2012,(01):27-30.
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2012年01期
页码:
27-30
栏目:
血管介入
出版日期:
2012-01-30

文章信息/Info

Title:
Selective bronchial artery embolization for the treatment of cryptogenic hemoptysis
作者:
池嘉昌; 许建荣; 沈加林; 张学彬; 程杰军; 庄治国
上海交通大学医学院附属仁济医院放射科，上海 200127
Author(s):
CHI Jia-chang;  XU Jian-rong;  SHEN Jia-lin;  ZHANG Xue-bin;  CHENG Jie-jun;  ZHUANG Zhi-guo.
 Department of Radiology, Affiliated Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
关键词:
 ; 【关键词】 咯血;  栓塞;  支气管动脉
文献标志码:
A
摘要:
【摘要】 目的 分析匿源性咯血患者支气管动脉造影的影像学表现,评估选择性支气管动脉栓塞术(BAE)治疗匿源性咯血的临床价值。方法 2004年6月至2011年3月对11例内科保守治疗无效的匿源性咯血患者行选择性BAE。术中行系统的主动脉造影及锁骨下动脉造影,观察责任血管的影像学表现及来源,并对双侧支气管动脉(BA)及非支气管性体动脉(NBSA)责任血管行选择性栓塞术。术后随访6个月 ~ 5年。结果 11例患者中10例为吸烟者(或有吸烟史)。所有患者术前CT增强检查及纤维支气管镜检查均未发现肺实质内与咯血有关的实质性病变。11例患者中,10例术中动脉造影存在血管异常表现,总共24支责任血管,其中右侧支气管动脉11支，左侧支气管动脉8支，胸廓内动脉2支，肋间动脉3支。术后8例咯血立即停止,2例仍有少量咯血经保守治疗后好转,1例术后仍有咯血,行肺叶切除术后好转。术后2例出现不同程度胸痛,1例出现发热,1例出现轻度肾功能不全,均经处理后缓解,所有患者均未出现其他严重的栓塞后并发症。所有患者术后1个月内无再次咯血,1例术后5个月咯血复发,经保守治疗后好转。结论 吸烟是匿源性咯血的一大危险因素, BA是匿源性大咯血的主要责任血管;选择性BAE治疗匿源性大咯血安全、有效,是首选的一线治疗手段.

参考文献/References:

[1] Bruzzi JF, Rémy-Jardin M, Delhaye D, et al. Multi-detector row CT of hemoptysis[J]. Radiographics, 2006, 26: 3 - 22.
[2] Yoon W, Kim JK, Kim YH, et al. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review[J]. Radiographics, 2002, 22: 1395 - 1409.
[3] Yoon YC, Lee KS, Jeong YJ, et al. Hemoptysis: bronchial and nonbronchial systemic arteries at 16-detector row CT[J]. Radiology, 2005, 234: 292 - 298.
[4] Parrot A, Antoine M, Khalil A, et al. Approach to diagnosis and pathological examination in bronchial Dieulafoy disease: a case series[J]. Respir Res, 2008, 9: 58.
[5] Samara KD, Tsetis D, Antoniou KM, et al. Bronchial artery embolization for management of massive cryptogenic hemoptysis: a case series[J]. J Med Case Reports, 2011, 5: 58.
[6] 王 超, 吕永兴, 邹英华. 超选择性支气管动脉栓塞治疗大咯血的临床评价[J]. 介入放射学杂志, 2008, 17: 737 - 739.
[7] Menchini L, Remy-Jardin M, Faivre JB. Cryptogenic haemoptysis in smokers: angiography and results of embolisation in 35 patients[J]. Eur Respir J, 2009, 34: 1031 - 1039.
[8] Hiyama J, Horita N, Shiota Y, et al. Cryptogenic hemoptysis and smoking[J]. Chest, 2002, 121: 1375 - 1376.
[9] 谭志斌, 郭 友, 陈 曌, 等. 支气管动脉栓塞治疗咯血短期疗效影响因素分析[J]. 放射学实践, 2009, 24: 1348 - 1350.
[10] Yoon W, Kim YH, Kim JK, et al. Massive hemoptysis: prediction of nonbronchial systemic arterial supply with chest CT[J]. Radiology, 2003, 227: 232 - 238.
[11] Yu-Tang Goh P, Lin M, Teo N, et al. Embolization for hemoptysis: a six-year review[J]. Cardiovasc Intervent Radiol, 2002, 25: 17 - 25.
[12] Charan NB, Baile EM, Paré PD. Bronchial vascular congestion and angiogenesis[J]. Eur Respir J, 1997, 10: 1173 - 1180.
[13] Hashimoto M, Tanaka H, Abe S. Quantitative analysis of bronchial wall vascularity in the medium and small airways of patients with asthma and COPD[J]. Chest, 2005, 127: 965 - 972.
[14] 江 森, 朱晓华, 孙兮文, 等. 非支气管性体动脉引起咯血的发病情况及介入栓塞疗效分析[J]. 中华放射学杂志, 2009, 43: 629 - 633.
[15] Keller FS, Rosch J, Loflin TG, et al. Nonbronchial systemic collateral arteries: significance in percutaneous embolotherapy for hemoptysis[J]. Radiology, 1987, 164: 687 - 692.
[16] Cauldwell E, Siekert R, Lininger M, et al. The bronchial arteries: an anatomic study in 150 human cadavers[J]. Surg Gynecol Obster, 1948, 86: 395 - 412.
[17] Do KH, Goo JM, Im JG. et al. Systemic arterial supply to the lungs in adults: spiral CT findings[J]. Radiographics, 2001, 21: 387 - 402.
[18] Hahn S, Kim YJ, Kwon W, et al. Comparison of the effectiveness of embolic agents for bronchial artery embolization: gelfoam versus polyvinyl alcohol[J]. Korean J Radiol, 2010, 11: 542 - 546.
[19] 祖庆泉, 施海彬, 杨正强, 等. 永久颗粒栓塞大咯血[J]. 介入放射学杂志, 2011, 20: 101 - 111.

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备注/Memo

备注/Memo:
 (收稿日期:2011-08-08)
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