隐源性咯血患者的DSA表现及介入栓塞治疗策略

摘要

Objective To explore the digital subtraction angiography (DSA) features and interventional embolization strategy of patients with cryptogenic hemoptyisis.Methods We retrospectively analyzed the DSA manifestations in patients with cryptogenetic hemoprysis,who were admitled to our liospital from January 2013 to December 2015 for interventional embolization stratrgy.The hemostatic and curative effects were observed after the operation.Results The main DSA showed the tortuous,thickening,disorders of responsible arteries,contrast agent spill,etc among the 36 patients.According to the DSA,the suitable interventional embolization method was chosen.Hemoptysis was stopped immediately after interventional embolization in all patients,and they were followed up for 11 months to 36 months.There were 5 cases (13.89％) with hemoptysis recurrence.The difference of simple gelatin sponge embolization,simple embolization microspheres embolization,embolization microspheres,gelatin sponge or coil mixed embolization was statistically significant in curative effect.Methods 2 and 3 were superior to method 1.Conclusion For patients with cryptogenic hemoptysis,the main DSA manifestations was bronchial artery abnormalities.The use of permanent embolization agent interventional embolization treatment,the recurrence rate is low,and the effect is significant.%目的 探讨隐源性咯血患者的DSA表现及介入栓塞治疗策略.方法 回顾性分析2013年1月～2015年12月入住我院隐源性咯血患者的DSA表现及介入栓塞治疗策略,术后观察止血效果并随访疗效.结果 36例患者的DSA主要表现为责任动脉迂曲、增粗、紊乱、对比剂外溢等.根据DSA表现选择合适的介入栓塞治疗策略,所有患者行介入栓塞治疗后咯血即刻停止.随访11～36个月,咯血复发5例,单纯明胶海绵栓塞(方法1),单纯栓塞微球栓塞(方法2),栓塞微球、明胶海绵或加用弹簧圈混合栓塞(方法3)3组在疗效上,差异具有统计学意义,方法2和3的疗效均优于方法1.结论 隐源性咯血患者的DSA主要表现为支气管动脉异常,使用永久性栓塞剂行介入栓塞治疗后,复发率低,疗效显著.