CAJ | 학술논문

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.
목적 탐토혈관내전새치료장기흡연자은원성대각혈적림상개치.방법 대21례유장기흡연사적은원성대각혈자행경도관동맥전새술(TAE).술중행계통적주동맥화쇄골하동맥조영,대지기관동맥(BA)화비지기관성체동맥진행평고,병대발현적병이성체동맥진행혈관조영화전새술.분석혈관조영표현,수방관찰TAE적림상효과화술후흉부CT표현.결과 21례환자적병이성체동맥균위BA,공35지,균유말소불동정도적증생,루급우폐24지,루급상협25지.BA주간증조24지,정상11지.소유BA균성공완성혈관내전새술.소유환자술후균획득즉각지혈,재수방시간내제1례유우발담중대혈외기여균미재복발각혈.수방적흉부CT시제원유폐기종표현외,폐내균미견기타이상.결론 장기흡연가치대각혈,책임혈관위BA,혈관내전새적효과현저.
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.