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1、【摘要】目的總結(jié)支氣管動(dòng)脈■肺循環(huán)痿的DSA表現(xiàn)和介入治療經(jīng)驗(yàn)。方法21例咯血病人,經(jīng)DSA證實(shí)存在支氣管動(dòng)脈■肺循環(huán)痿，根據(jù)血管痿的類型、數(shù)目、痿口的人小、循環(huán)吋間選擇不同種類和人小的栓塞劑對痿口和病變血管進(jìn)行栓塞。對其中6例DSA可見到明確痿口并且循環(huán)時(shí)間短于1see的病人，先用明膠海綿顆粒對痿口作預(yù)栓塞，然后用t約1mm的5?0真絲線段進(jìn)一步栓塞。其余15例循環(huán)吋間長于Isec者，直接用真絲線段進(jìn)行栓塞。栓塞術(shù)后隨訪0.5~3y,評估治療效果。結(jié)果DSA表現(xiàn)為支氣管動(dòng)脈■肺動(dòng)脈痿和支氣管動(dòng)脈■肺靜脈痿者分別為15例和6例，同吋合并肋間動(dòng)脈■肺循環(huán)痿者5例。其中17例經(jīng)支
2、氣管動(dòng)脈栓塞后達(dá)到即刻止血效果，有3例栓塞術(shù)后咯血量明顯減少，經(jīng)保守治療后痊愈出院?？傆行蕿?5.2%o另1例因肋間動(dòng)脈和鎖骨下動(dòng)脈參與供血，未能有效止血，在介入術(shù)后6h轉(zhuǎn)胸外科手術(shù)治療。經(jīng)隨訪發(fā)現(xiàn)，有2例分別在介入栓塞后4m和11m復(fù)發(fā)，5例在19m內(nèi)死于肺癌合并癥。結(jié)論支氣管動(dòng)脈■肺循環(huán)痿在咯血病人中是常見的血管異常，可加重咯血和心肺疾病的進(jìn)展,經(jīng)皮穿刺支氣管動(dòng)脈栓塞術(shù)是有效的治療方法?！娟P(guān)鍵詞】咯血；支氣管動(dòng)脈；栓塞，治療性；治療結(jié)杲TheDSAfindingsandtheinterventionaltherapyexperienceofbronchialartery
3、topulmonarycirculationshunt.LVWei-fu*,ZHANGXing-ming,ZHANGXue-bin,ZHANGZhen-feng,HOUChang-long,HUShu-dong.^DepartmentofRadiology,AnhuiProvincialHospital,Hefei230(X)l,China[Abstract)ObjectiveToanalysistheDSAfindingsandinterventionaltherapyexperienceofbronchialarterytopulmonarycirculationshun
4、t(BPS).MethodsBPSwereconfirmedbyDSAin21patientswithhemoptysis.Thedisordervesselswereembolizedusingvariouskindsandsizesembolismparticleswithaccordingtotheshunttipeandnumber,theshuntorificesizeandcirculationtime.In6patientswithin1seccirculationtime,theshuntorificeswerepre-embolizedusinggelfoa
5、mparticles,and5-()silksegmentsmeasuringabout1mmwereusedforcompensativeembolism.Theremaining15patientsbeyong1seccirculationtimewereembolizedonlyusingsilksegments.ResultsAccordingtoDSAfindings,bronchialarterytopulmonaryarteryshuntandbronchialarterytopulmonaryveinshuntwereconfirmedin15and6pati
6、ents,respectively.Amongthem,17patientsstopbleedinginstantlyafterembolization,andthebleedingdecreasedsignificantlyinthe3patients.Thetotaleffectiveratewas95.2%。Theremainingonewasinefficiencyduetothebloodsupplycomingfromintercostalarteriesandsubclavianartery,whowasperformedbysurgicalinterventi
7、on6hoursafterembolization.Thefollowing-uprevealedthathemoptysisre-occurredin2patients4monthsand11monthsrespectivelyafterembolizationand5patientsdiedduetopulmonarycancerwithin19months?ConclusionBPSisacommonvesselabnormalityinthepatientswithhemoptysis.ltca
