CAJ | 학술논문

目的：探讨血管内栓塞治疗隐源性大咯血的临床应用价值。方法对6例内科保守治疗无效的隐源性大咯血患者行超选择性支气管动脉栓塞（ BAE），术中行主动脉造影。对支气管动脉（ BA）和非支气管动脉（ NBSA）进行评估，分析血管造影表现。随访观察BAE的临床效果及术后肺部CT表现。结果6例患者中4例有吸烟史，血管造影共发现15支BA，肋间动脉3支。呈病理性改变11支，其主干增粗，可见血管末梢不同程度的增生，主干正常4支。所有患者BAE后即刻获得止血，随访时间内均未再发咯血，术后CT扫描未见异常。结论 BA是隐源性大咯血的主要责任血管，长期吸烟可能是导致隐源性咯血的主要因素，超选择性BAE治疗隐源性大咯血安全、疗效显著。
목적：탐토혈관내전새치료은원성대각혈적림상응용개치。방법대6례내과보수치료무효적은원성대각혈환자행초선택성지기관동맥전새（ BAE），술중행주동맥조영。대지기관동맥（ BA）화비지기관동맥（ NBSA）진행평고，분석혈관조영표현。수방관찰BAE적림상효과급술후폐부CT표현。결과6례환자중4례유흡연사，혈관조영공발현15지BA，륵간동맥3지。정병이성개변11지，기주간증조，가견혈관말소불동정도적증생，주간정상4지。소유환자BAE후즉각획득지혈，수방시간내균미재발각혈，술후CT소묘미견이상。결론 BA시은원성대각혈적주요책임혈관，장기흡연가능시도치은원성각혈적주요인소，초선택성BAE치료은원성대각혈안전、료효현저。
Objective To investigate the clinical application value of endovascular embolization on cryptogenic massive he-moptysis. Methods Super selective bronchial artery embolization( BAE)was given for 6 cases of cryptogenic hemoptysis with invalid internal medicine conservative treatment,and aortic angiography was performed during BAE. Bronchial artery( BA)and nonbronchial systemic artery( NBSA)was evaluated,and the angiographic signs were analyzed. The clinical effects and postopera-tive lung CT manifestations of BAE were observed. Results Among the 6 patients,4 patients had smoking history,15 bronchial arteries were found by angiography,3 intercostal arteries were found. Eleven systemic arteries with pathologic changes were found,with enlarged trunk and visible different degrees of hyperplasia of peripheral blood vessels,4 normal trunks were found. All patients had hemostasis immediately after BAE,and there was no recurrence of hemoptysis during the follow-up. Postopera-tive CT scan did not show any abnormalities. Conclusion Bronchal arteries are the primary feeding vessels in cryptogenic he-moptysis,and long-term smoking is one of the main risk factors for cryptogenic hemoptysis,super selective BAE is effective and safe for treatment of cryptogenic hemoptysis.