CAJ | 학술논문

目的：探讨肺血管畸形大咯血患者的血管造影表现及急诊动脉栓塞治疗（emergency transcatheter arterial embolization ，ETAE）的疗效。方法38例肺血管畸形大咯血患者采用急诊介入造影检查，明确出血部位后，采用丙烯酸微球（tricacryl gelatin microphere ，T AGM ）和明胶海绵条对出血动脉行急诊栓塞治疗，对动脉造影表现及治疗结果进行回顾性分析。结果38例患者共找到并成功栓塞52支出血动脉。22例诊断为支气管动脉‐肺动脉瘘；8例为肋间动脉—肺动脉瘘；4例患者为甲状颈干—肺动脉瘘；支气管动脉—肺静脉瘘及肋间动脉—肺静脉瘘各2例。7例患者栓塞止血后择期行患侧肺叶手术切除。栓塞术后随访12个月，所有栓塞治疗后的患者均无复发咯血。结论 ETAE治疗肺血管畸形大咯血是一种创伤小、安全、疗效确切的治疗手段。认识咯血病变血管的多源性和供血方式的复杂性是治疗成功的前提，对所有供血动脉的彻底栓塞是治疗成功的关键。
목적：탐토폐혈관기형대각혈환자적혈관조영표현급급진동맥전새치료（emergency transcatheter arterial embolization ，ETAE）적료효。방법38례폐혈관기형대각혈환자채용급진개입조영검사，명학출혈부위후，채용병희산미구（tricacryl gelatin microphere ，T AGM ）화명효해면조대출혈동맥행급진전새치료，대동맥조영표현급치료결과진행회고성분석。결과38례환자공조도병성공전새52지출혈동맥。22례진단위지기관동맥‐폐동맥루；8례위륵간동맥—폐동맥루；4례환자위갑상경간—폐동맥루；지기관동맥—폐정맥루급륵간동맥—폐정맥루각2례。7례환자전새지혈후택기행환측폐협수술절제。전새술후수방12개월，소유전새치료후적환자균무복발각혈。결론 ETAE치료폐혈관기형대각혈시일충창상소、안전、료효학절적치료수단。인식각혈병변혈관적다원성화공혈방식적복잡성시치료성공적전제，대소유공혈동맥적철저전새시치료성공적관건。
Objective To explore the curative effect of emergency transcatheter arterial embolization (ETAE) in patients with massive hemoptysis caused by pulmonary‐vascular abnormalities .Methods 38 cases of massive hemoptysis caused by pulmonary‐vascular abnormalities underwent emergency arteriography .After bleeding arteries were located ,the patients were given embolotherapy with tricacryl gelatin microphere (TAGM ) and gelfoam strips .The arteriography manifesta‐tions and therapeutic outcome of all 38 patients were retrospectively analysed .Results 52 bleeding arteries were located and embolized successfully in 38 patients .22 patients were diagnosed with bronchial artery‐pulmonary artery fistul ;8 pa‐tients were diagnosed with intercostal artery‐pulmonary artery fistul ;4 patients were diagnosed with thyrocervical trunk‐pulmonary artery fistul ;Bronchial artery‐pulmonary vein fistul and intercostal artery‐pulmonary vein fistul were diagnosed both two case .Pulmonary lobectomy was performed in 7 patients after hemostasis of embolotherapy .After 12‐month fol‐low‐up ,all patients had no recurrence haemoptysis after the embolotherapy .Conclusion ETAE is a small trauma ,safety and efficacy treatment for the massive hemoptysis caused by pulmonary‐vascular abnormalities .The precondition of suc‐cessful treatment is to know the polyphyly of haemoptysis disease blood vessels and the complexity of blood supply .The key of successful treatment is to completely embolize all blood supply arteries .