摘要
目的探讨CT血管成像在动脉栓塞治疗咯血中的临床应用价值。方法选取2013年5月至2014年12月因咯血在我科行介入栓塞治疗的45例患者为研究对象。分为2组,介入术前患者进行咯血责任动脉CT血管成像为A组、否则为B组。结果 2组患者动脉造影共找到相关责任动脉56支,包括支气管动脉45支,肺外体循环动脉11支。所有患者均成功完成介入治疗,手术操作成功率100%,短期止血成功率(术后连续随访3个月)98%(44/45)。A组中,术前行CTA检查共找到责任动脉32支,术中行DSA共找到责任动脉34支,以DSA检查为标准,介入术前行咯血责任动脉CTA诊断敏感度为94%。与B组相比,A组介入术中更容易选择至出血责任动脉,而且在首次成功超选择至靶支气管动脉的透视时间、总透视时间、总手术时间及对比剂用量方面,2组结果差异有统计学意义(P<0.05),A组优势明显。结论支气管动脉栓塞术治疗咯血起效迅速,介入术前进行无创性的支气管动脉CTA检查,可较全面显示咯血病变区责任动脉的开口、走行、主要分支等特征,发现是否有肺外体循环相关动脉参与病变供血,缩短介入手术时间、辐射时间,减少对比剂用量,减少并发症的发生率,有效提高咯血介入治疗的效果,具有重要的临床应用价值。
Objective To study the clinical application value of the CT angiography in interventional treatment haemoptysis. Methods There are 45 patients with hemoptysis undergoing interventional embolization treatment,from may 2013 to December 2014, aged from 27 to 82. All patients were divided into two groups, patients with the examina- tion of artery CT angiography（CTA）before interventional treatment was in group A, others in group B. Results Fifty- six responsible arteries were found in two groups undergoing DSA, including 45 bronchial arteries （BA）, 11 non- bronchial systemic arteries. All patients were underwent interventional therapy successfully, interventional embolization operation success rate 100%, short-term success rate of hemostasis （continuous postoperative follow-up of 3 months） was 98% （44/45）. Thirty-two responsibility arteries at preoperative multi-detector row CTA in the group A were found, 34 at DSA, the sensitivity at CTA was 94%. Compared with group B, the operation doctor is easier to find responsibility artery in group A. In the effective exposure time of the first successful choose to target artery, total exposure time, total operative time and dosage of used contrast agent, the differences of two groups was statistically significant （P〈0.05）. The A group has obvious advantages. Conclusion Hemostatic effect to patients with hemoptysis undergoing bronchial artery embolization was quickly. Preoperative noninvasive CTA examination can fully show the ostium and the course of the responsibility artery, main branches, and find whether there are nonbronchial systemic arteries, shorten the inter- vention operation time, radiation time, reduce the dosage of contrast agent, reduce the incidence of complications, effec- tively improve the haemoptysis effectiveness of interventional treatment, has important clinical value.
出处
《实用医学影像杂志》
2017年第1期21-24,共4页
Journal of Practical Medical Imaging
关键词
咯血
支气管动脉
冠状血管造影术
Hemoptysis
Bronchial arteries
Coronary angiography
