摘要
目的探讨介入栓塞治疗非支气管动脉系统来源咯血的疗效及安全性。方法回顾性分析2017年2月~2024年11月介入栓塞治疗23例非支气管动脉系统来源咯血的临床资料。出血责任血管仅为非支气管动脉系统6例,同时来自非支气管动脉系统和支气管动脉17例。非支气管动脉系统来源包括肋间动脉14支,甲状颈干5支,肩胛下动脉5支,胸廓内动脉4支,胸廓外动脉3支,膈动脉5支,肾动脉1支,胃左动脉1支。均行介入栓塞治疗。随访复发率,记录术后并发症。结果术后即刻止血率95.7%(22/23)。1例因漏栓膈动脉导致术后24 h内再次咯血,二次栓塞后内未再咯血。术后腹部不适1例,发热2例,胸痛2例,保守治疗后症状消失。术后随访4~36个月(中位数30个月),20例未再咯血,3例咯血复发(分别为术后4、4、36个月),复发率13.0%(3/23),无严重并发症发生。结论介入栓塞治疗非支气管动脉系统来源咯血疗效确切,安全可行。
Objective To explore the efficacy and safety of interventional embolism in the treatment of hemoptysis from non-bronchial arterial system.Methods We retrospectively analyzed clinical data of 23 cases of non-bronchial artery system derived hemoptysis from February 2017 to November 2024.The hemorrhagic blood vessels were only the non-bronchial artery system in 6 cases,and from the non-bronchial artery system and bronchial arteries in 17 cases.Sources of non-bronchial artery systems included 14 intercostal arteries,5 thyrocervical trunk,5 subscapular arteries,4 internal thoracic arteries,3 external thoracic arteries,5 diaphragmatic arteries,1 renal artery,and 1 left gastric artery.All the patients were treated with interventional embolism.Recurrence rate was followed up and postoperative complications were recorded.Results The immediate hemostasis rate after surgery was 95.7%(22/23).In one case,hemoptysis was relapsed within 24 h after the operation due to omission of diaphragmatic artery,and hemoptysis did not recurred after the secondary embolization.After surgery,there was 1 case of abdominal discomfort,2 cases of fever,and 2 cases of chest pain.The symptoms disappeared after conservative treatment.After the operation,the follow-up was 4-36 months(median,30 months).A total of 20 patients did not re-develop hemoptysis,while 3 had relapsed hemoptysis at 4 months,4 months,and 36 months after operation,respectively,with a recurrence rate of 13.0%(3/23).No serious complications occurred.Conclusion Interventional embolism is effective in the treatment of non-bronchial hemoptysis,which is safe and feasible.
作者
左淑娟
梁昊
詹鹏超
郑鸣
申猛
李照军
陈清亮
Zuo Shujuan;Liang Hao;Zhan Pengchao(不详;Radiology Interventional Department,Henan Provincial Third People’s Hospital,Zhengzhou 450006,China)
出处
《中国微创外科杂志》
北大核心
2025年第10期623-627,共5页
Chinese Journal of Minimally Invasive Surgery
基金
河南省医学科技攻关计划联合共建项目(LHGJ20240648)
河南省慈善联合总会·道健基金科研立项(szsyky24028)
郑州市医疗卫生科技创新指导计划项目(2024YLZDJH044)。
关键词
咯血
肺-体循环
非支气管动脉
介入栓塞
Hemoptysis
Lung-body circulation
Non-bronchial artery
Interventional embolism
