摘要
目的 探讨血管内栓塞治疗长期吸烟者隐原性大咯血的临床价值.方法 对21例有长期吸烟史的隐原性大咯血者行经导管动脉栓塞术（TAE）.术中行系统的主动脉和锁骨下动脉造影,对支气管动脉（BA）和非支气管性体动脉进行评估,并对发现的病理性体动脉进行血管造影和栓塞术.分析血管造影表现,随访观察TAE的临床效果和术后胸部CT表现.结果 21例患者的病理性体动脉均为BA,共35支,均有末梢不同程度的增生,累及右肺24支,累及上叶25支.BA主干增粗24支,正常11支.所有BA均成功完成血管内栓塞术.所有患者术后均获得即刻止血,在随访时间内除1例有偶发痰中带血外其余均未再复发咯血.随访的胸部CT示除原有肺气肿表现外,肺内均未见其他异常.结论 长期吸烟可致大咯血,责任血管为BA,血管内栓塞的效果显著.
Objective To determine the effectiveness of endovascular embolization in patients with cryptogenic massive hemoptysis who were all long-term smokers.Methods Aortography and subclavian artery angiography were performed in 21 long-term smokers with cryptogenic massive hemoptysis.Transarterial embolization （TAE） was performed in patients with detectable pathologic systemic arteries.The angiographic findings were reviewed and the clinical and follow-up CT results were observed.Results The pathologic systemic arteries were all bronchial arteries （BAs） and thirty-five arteries were involved.The angiography demonstrated peripheral hyperplasia in all BAs,with 24 pathologic BAs supplying the right lung and 25 supplying the upper lobes.In thirty-five BAs,24 showed hypertrophy and 11 were normal.TAE of the pathologic BAs was successfully performed and cessation of bleeding was achieved in all patients.During follow-up,one patient had episodic bloody sputum after embolization and no recurrence in all patients.The follow-up CT demonstrated no additional abnormality besides pre-existing pulmonary emphysema.Conclusion Cryptogenic massive hemoptysis in long-term smokers efficiently treated by endovascular embolization of the responsible bronchial artery.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2011年第12期1199-1202,共4页
Chinese Journal of Radiology
关键词
咯血
栓塞
治疗性
吸烟
肺疾病
慢性阻塞性
Hemoptysis
Embolization, therapeutic
Smoking
Pulmonary disease
chronic obstructive
