切换至 "中华医学电子期刊资源库"
高级检索
中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2016, Vol. 04 ›› Issue (01) : 13 -16. doi: 10.3877/cma.j.issn.2095-5782.2016.01.004

所属专题： 文献；

血管介入

支气管动脉CTA对介入栓塞治疗咯血的指导及应用价值
笪彬彬1, 赵卫1,†(), 姜永能1, 石潆1   
  1. 1. 650032　昆明医科大学第一附属医院医学影像科
  • 收稿日期:2015-11-12 出版日期:2016-02-01
  • 通信作者: 赵卫

Clinical value of bronchial artery CTA on interventional embolization in the treatment of hemoptysis

Binbin Da1, Wei Zhao1,†(), Yongneng Jiang1, Ying Shi1   

  1. 1. Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Yunnan 650032, China
  • Received:2015-11-12 Published:2016-02-01
  • Corresponding author: Wei Zhao
  • About author:
    Corresponding author:Zhao Wei,Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

笪彬彬, 赵卫, 姜永能, 石潆. 支气管动脉CTA对介入栓塞治疗咯血的指导及应用价值[J]. 中华介入放射学电子杂志, 2016, 04(01): 13-16.

Binbin Da, Wei Zhao, Yongneng Jiang, Ying Shi. Clinical value of bronchial artery CTA on interventional embolization in the treatment of hemoptysis[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2016, 04(01): 13-16.

目的

探讨支气管动脉CT血管成像（CTA）对咯血介入治疗的指导作用及效果。

方法

将34例咯血患者按介入栓塞治疗前是否行支气管动脉CTA检查分为单纯DSA组及术前CTA组，每组17例。比较两组检出可疑出血动脉情况、手术时间及术后一年复发率，分析术前CTA组的CTA血管检出率。

结果

术前CTA组共检出可疑出血动脉28支，单纯DSA组检出31支，并全部予以栓塞。术前CTA组的手术时间为（28.33±7.68）min，低于单纯DSA组的（40.55±10.01）min，差异有统计学意义（t=4.03，P<0.05）。

结论

支气管动脉CTA可以客观评价咯血相关血管的起源、数目及走形，可为术中寻找出血动脉提供准确的定位。并且能减少手术时间及医患人员的辐射剂量，避免漏栓，降低复发几率，对指导咯血的介入治疗有重要的临床应用价值。

关键词: 咯血, 支气管动脉, CT血管造影, 介入治疗
Objective

To evaluate the role of bronchial artery CTA on interventional embolization in the treatment of hemoptysis.

Methods

34 cases treated with interventional embolization for hemoptysis was included in the study. They were divided into two groups according to whether bronchial artery CTA was performed. Group A (n=17) is those who performed DSA directly without preoperative CTA, while group B (n=17) is those with preoperative CTA peformed.The results of CTA and DSA, technical and clinical outcomes were compared and analyzed.

Results

28 hemorrhage arteries were identified in group B while 31 in group A. All these identified arteries were embolized successfully. The ray time of group B is shorter than group A ( min:28.33±7.68 vs. 40.55±10.01, t=4.03, P <0.05).

Conclusions

Bronchial artery CTA can objectively evaluate hemoptysis associated vascular origin, number and shape, but the bleeding artery to provide accurate positioning for intraoperative finding. And can reduce the radiation dose of operation time and the doctors and patients, to avoid leakage bolt reduce the recurrent rate of hemoptysis interventional therapy guidance has wide clinical application value.

Key words: Hemoptysis, Bronchial artery, CT angiography, Interventional therapy
图1 男性患者，24岁，咯血10天。
图2 男性患者，47岁，诊断为支气管扩张症。
表1 术前CTA组与单纯DSA组检出动脉比较（支）
出血动脉 术前CTA组（n=17） 单纯DSA组（n=17）
支气管动脉 17 18
肋间动脉 7 8
胸廓内动脉 1 2
甲状劲干 1 1
膈下动脉 2 2
合计 28 31
1
Gupta M,Srivastava DN,Seith A et al.Clinical impact of multidetector row computed tomography before bronchial artery embolization in patients with hemoptysis: a prospective study[J].Can Assoc Radiol J,2013,64(1):61-73. doi: 10.1016/j.carj.2011.08.002.
2
Fruchter O, Schneer S, Rusanov V, et al. Bronchial artery embolization for massive hemoptysis: long-term follow-up[J]. Asian Cardiovasc Thorac Ann,2015 ,23(1):55-60. doi: 10.1177/0218492314544310.
3
Nugent Z,Oliveira V,Maclusky I,et al.Bronchial artery-pulmonary artery malformation as a cause of cryptogenic hemoptysis[J].Pediatr Pulmonol,2013,48(9):930-933doi: 10.1002/ppul.22689.
4
Lee MK, Kim SH, Yong SJ, et al. Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization[J]. Clin Respir J, 2015 ,9(1):53-64. doi: 10.1111/crj.12104.
5
李建军,翟仁友,戴定可,等. 支气管动脉栓塞术治疗咯血的疗效分析[J]. 介入放射学杂志,2007,16(1):21-23.
6
顾俊鹏,顾朋,迪力木拉提·巴吾东,等.大咯血的介入治疗及复发的影响因素分析[J]. 介入放射学杂志,2012,21(11):952-957. doi: 10.3969/j.issn.1008-794X.2012.11.017
7
丁健,王永利,王征宇, 等. "三明治"式支气管动脉栓塞术治疗咯血的临床疗效分析[J]. 介入放射学杂志,2014,23(3):245-249. doi:10.3969/j.issn.1008-794X.2014.03.016
8
Lin Y,Chen Z,Yang X, et al.Bronchial and non-bronchial systemic arteries:value of multidetector CT angiography in diagnosis and angiographic embolisation feasibility analysis[J].J Med Imaging Radiat Oncol, 2013, 57(6):644-651. doi: 10.1111/1754-9485.12058.
9
Natsis K,Asouhidou I,Vizas V, et al.A rare cadaveric finding of ectopic origin of a bronchial artery: surgical and imaging consequences[J].Folia Morphol (Warsz),2013,72(1):78-81
10
金书强,徐伟,白彬. 非支气管性体动脉参与供血的大咯血的急诊介入栓塞治疗[J]. 医学影像学杂志,2014,24(1):36-39.
11
Morita Y,Takase K, Ichikawa H, et al. Bronchial artery anatomy: preoperative 3D simulation with multidetector CT[J].Radiology,2010,255(3):934-943. doi: 10.1148/radiol.10081220.
12
Mi S,Zhang LM,Mao WP, et al.The evaluation of combined CT pulmonary and bronchial arteriography for the diagnosis of hemoptysis[J].Zhonghua Jie He He Hu Xi Za Zhi,2012,35(1):42-44
13
Jiang S, Sun XW, Jie B, et al. Endovascular embolization of an aberrant bronchial artery originating from the vertebral artery in a patient with massive hemoptysis[J]. Cardiovasc Intervent Radiol,2013,37(4):1099-1102. doi: 10.1007/s00270-013-0778-9.
[1] 王玉琳, 孙晓容. 晚期肺癌大咯血输注垂体后叶素渗漏救治成功一例[J]. 中华肺部疾病杂志(电子版), 2023, 16(03): 451-452.
[2] 魏小勇. 原发性肝癌转化治疗焦点问题探讨[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 602-607.
[3] 刘中百, 任勇军. 肝细胞癌的介入治疗现状及进展[J]. 中华消化病与影像杂志(电子版), 2023, 13(02): 111-115.
[4] 张德伟, 雷毅, 江哲宇, 王黎洲, 许国辉, 周石. 杂交手术治疗下肢深静脉血栓合并下肢急性动脉血栓一例[J]. 中华介入放射学电子杂志, 2023, 11(04): 380-384.
[5] 李世凯, 梁佳, 何艳艳, 于毅, 李天晓, 常金龙, 贺迎坤. 兔颈动脉粥样硬化性狭窄模型在介入治疗的应用进展[J]. 中华介入放射学电子杂志, 2023, 11(04): 357-362.
[6] 林加文, 印于, 杨俊, 朱晓黎, 王万胜. 肝动门静脉瘘合并腹水一例[J]. 中华介入放射学电子杂志, 2023, 11(03): 289-291.
[7] 董艳超, 牛洪涛. 封堵球囊微导管在超选择性动脉栓塞时应用价值与安全性综述[J]. 中华介入放射学电子杂志, 2023, 11(02): 164-171.
[8] 季鹏, 郭言言, 王超. CT灌注成像联合CT血管造影对TIA患者进展为急性脑梗死的预测[J]. 中华介入放射学电子杂志, 2023, 11(02): 128-132.
[9] 吴雅琴, 莫伟, 向华, 李琴, 李兰. 肝癌患者介入治疗穿刺处出血影响因素的真实世界研究[J]. 中华介入放射学电子杂志, 2023, 11(02): 117-122.
[10] 曾嘉, 何东风. 介入栓塞材料在肝癌治疗中的研究进展[J]. 中华介入放射学电子杂志, 2023, 11(01): 62-67.
[11] 张正宇, 谢兴武, 周雪惠, 陈光斌. DSA引导下经皮动脉栓塞治疗腹壁下动脉出血一例[J]. 中华介入放射学电子杂志, 2023, 11(01): 82-83,88.
[12] 陈丹丹, 潘文志, 陈莎莎, 张源, 张晓春, 李明飞, 周达新, 葛均波. 结构性心脏病年度报告2022[J]. 中华心脏与心律电子杂志, 2023, 11(03): 129-140.
[13] 孙相利, 许真真. 经皮冠状动脉旋磨术在冠状动脉重度钙化病变介入治疗中的应用[J]. 中华老年病研究电子杂志, 2023, 10(02): 33-36.
[14] 姜新鹏, 李晓明, 杨航, 宫一宸, 傅元豪, 傅瑜, 张喆. 单纯经胸超声心动图引导卵圆孔未闭封堵术早期安全性及有效性分析[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 320-324.
[15] 连万成, 姚京, 吴泽涛, 何毅, 伍健明, 张猛. 血流导向装置治疗颅内未破裂动脉瘤的疗效与影响因素分析[J]. 中华脑血管病杂志(电子版), 2023, 17(01): 31-36.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号