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1、【摘要】目的总结支气管动脉■肺循环痿的DSA表现和介入治疗经验。方法21例咯血病人,经DSA证实存在支气管动脉■肺循环痿，根据血管痿的类型、数目、痿口的人小、循环吋间选择不同种类和人小的栓塞剂对痿口和病变血管进行栓塞。对其中6例DSA可见到明确痿口并且循环时间短于1see的病人，先用明胶海绵颗粒对痿口作预栓塞，然后用t约1mm的5・0真丝线段进一步栓塞。其余15例循环吋间长于Isec者，直接用真丝线段进行栓塞。栓塞术后随访0.5~3y,评估治疗效果。结果DSA表现为支气管动脉■肺动脉痿和支气管动脉■肺静脉痿者分别为15例和6例，同吋合并肋间动脉■肺循环痿者5例。其中17例经支
2、气管动脉栓塞后达到即刻止血效果，有3例栓塞术后咯血量明显减少，经保守治疗后痊愈出院。总有效率为95.2%o另1例因肋间动脉和锁骨下动脉参与供血，未能有效止血，在介入术后6h转胸外科手术治疗。经随访发现，有2例分别在介入栓塞后4m和11m复发，5例在19m内死于肺癌合并症。结论支气管动脉■肺循环痿在咯血病人中是常见的血管异常，可加重咯血和心肺疾病的进展,经皮穿刺支气管动脉栓塞术是有效的治疗方法。【关键词】咯血；支气管动脉；栓塞，治疗性；治疗结杲TheDSAfindingsandtheinterventionaltherapyexperienceofbronchialartery
3、topulmonarycirculationshunt.LVWei-fu*,ZHANGXing-ming,ZHANGXue-bin,ZHANGZhen-feng,HOUChang-long,HUShu-dong.^DepartmentofRadiology,AnhuiProvincialHospital,Hefei230(X)l,China[Abstract)ObjectiveToanalysistheDSAfindingsandinterventionaltherapyexperienceofbronchialarterytopulmonarycirculationshun
4、t(BPS).MethodsBPSwereconfirmedbyDSAin21patientswithhemoptysis.Thedisordervesselswereembolizedusingvariouskindsandsizesembolismparticleswithaccordingtotheshunttipeandnumber,theshuntorificesizeandcirculationtime.In6patientswithin1seccirculationtime,theshuntorificeswerepre-embolizedusinggelfoa
5、mparticles,and5-()silksegmentsmeasuringabout1mmwereusedforcompensativeembolism.Theremaining15patientsbeyong1seccirculationtimewereembolizedonlyusingsilksegments.ResultsAccordingtoDSAfindings,bronchialarterytopulmonaryarteryshuntandbronchialarterytopulmonaryveinshuntwereconfirmedin15and6pati
6、ents,respectively.Amongthem,17patientsstopbleedinginstantlyafterembolization,andthebleedingdecreasedsignificantlyinthe3patients.Thetotaleffectiveratewas95.2%。Theremainingonewasinefficiencyduetothebloodsupplycomingfromintercostalarteriesandsubclavianartery,whowasperformedbysurgicalinterventi
7、on6hoursafterembolization.Thefollowing-uprevealedthathemoptysisre-occurredin2patients4monthsand11monthsrespectivelyafterembolizationand5patientsdiedduetopulmonarycancerwithin19months・ConclusionBPSisacommonvesselabnormalityinthepatientswithhemoptysis.ltca
