CAJ | 학술논문

目的：探讨甲状颈干动脉栓塞在肺咯血动脉栓塞治疗中的临床应用。方法：选取9例经内科止血治疗无效的肺结核咯血患者，在完成支气管动脉和肋间动脉造影栓塞后，对锁骨下动脉造影，发现甲状颈干动脉分支可疑参与病变供血后，对甲状颈干动脉进行超选择性插管、造影和栓塞，并观察其疗效、术后反应及并发症。结果：超选择性甲状颈干动脉造影显示，供血甲状颈干分支有不同程度扭曲、增粗、增生、扩张以及动脉与肺动脉分流。均未见明确造影剂外溢和肺静脉分流，基础病变均为慢性纤维空洞型肺结核，栓塞术后即时止血率为100%。患者术后均有中低度发热及胸背痛，仅1例发生严重疼痛，无呼吸困难、脊髓损伤及异位栓塞等并发症出现。9例患者随访期均＞1年，仅1例患者动脉栓塞术后第14个月再咯血。结论：肺结核大咯血动脉栓塞治疗时应警惕甲状颈干供血，对其进行栓塞以完善治疗效果，超选择性插管后再栓塞可以保证其安全性。
목적：탐토갑상경간동맥전새재폐각혈동맥전새치료중적림상응용。방법：선취9례경내과지혈치료무효적폐결핵각혈환자，재완성지기관동맥화륵간동맥조영전새후，대쇄골하동맥조영，발현갑상경간동맥분지가의삼여병변공혈후，대갑상경간동맥진행초선택성삽관、조영화전새，병관찰기료효、술후반응급병발증。결과：초선택성갑상경간동맥조영현시，공혈갑상경간분지유불동정도뉴곡、증조、증생、확장이급동맥여폐동맥분류。균미견명학조영제외일화폐정맥분류，기출병변균위만성섬유공동형폐결핵，전새술후즉시지혈솔위100%。환자술후균유중저도발열급흉배통，부1례발생엄중동통，무호흡곤난、척수손상급이위전새등병발증출현。9례환자수방기균＞1년，부1례환자동맥전새술후제14개월재각혈。결론：폐결핵대각혈동맥전새치료시응경척갑상경간공혈，대기진행전새이완선치료효과，초선택성삽관후재전새가이보증기안전성。
Objective:To discuss the clinical application of thyrocervical trunk arterial(TTA) embolization in artery embolism for hemoptysis of tuberculosis.Methods: Nine cases of hemoptysis undertook TTA angiography and embolization after embolizing with bronchial and intercostal arteries and subclavian artery angiography. All cases were analyzed for clinical efficacy and complications.Results: Hemorrhagic TTA appeared tortuosity, dilatation, hyperplasia, aneurysm, shunt with pulmonary artery. Extravasation of contrast media and shunt with pulmonary vein were not observed. All patients had chronic fibro cavernous pulmonary tuberculosis. The postoperative immediate cessation rate of hemoptysis reached 100%. The complications occurred with fever, chest-back pain. Severe pain was observed in 1 patient. There were no spinal cord injuries and abnormal position embolization postoperatively. Among 9 cases with long follow up term more than 1 year, hemoptysis was recurred in one patient after 14 months of embolization.Conclusion: Interventional radiologist should mind TTA supply to lesions when undertaking bronchial artery embolization for hemoptysis of pulmonary tuberculosis. TTA embolization is safety and improve therapeutic efficacy in artery embolism for hemoptysis.