本文選題：咯血 + 肱動(dòng)脈　； 參考：《中國(guó)介入影像與治療學(xué)》2016年04期

【摘要】：目的探討經(jīng)肱動(dòng)脈入路行胸廓內(nèi)動(dòng)脈(ITA)急診栓塞治療大咯血的療效。方法回顧性分析13例經(jīng)肱動(dòng)脈入路行ITA栓塞術(shù)治療大咯血的臨床資料。選用明膠海綿條、聚乙烯醇(PVA)顆粒及彈簧圈選擇性栓塞出血的動(dòng)脈,對(duì)動(dòng)脈造影的表現(xiàn)及治療結(jié)果進(jìn)行總結(jié)及評(píng)價(jià)。結(jié)果 13例患者共找到并成功栓塞13支病變的ITA。經(jīng)股動(dòng)脈入路選擇失敗的原因:6例因鎖骨下動(dòng)脈扭曲嚴(yán)重,7例因ITA開口變異。出血?jiǎng)用}造影主要表現(xiàn)為增粗,分支增多、紊亂及新生血管形成。3例患者栓塞止血后行病變肺葉切除術(shù)。所有患者術(shù)后隨訪1年均無再次咯血。結(jié)論對(duì)于懷疑有ITA出血但經(jīng)股動(dòng)脈入路選擇困難的大咯血患者,肱動(dòng)脈入路可作為很好的技術(shù)補(bǔ)充手段。
[Abstract]:Objective to investigate the effect of emergency embolization of internal thoracic artery via brachial artery approach for massive hemoptysis. Methods Clinical data of 13 patients with massive hemoptysis underwent ITA embolization via brachial artery approach were retrospectively analyzed. Selective embolization of haemorrhagic arteries with gelatin sponge, polyvinyl alcohol PVA (PVA) granules and coils was used to summarize and evaluate the findings and therapeutic results of arteriography. Results 13 patients were found and successfully embolized 13 branches of ITAA. The reason for the failure of transfemoral approach was that 6 cases were due to severe distortion of subclavian artery and 7 cases were due to ITA variation. The main manifestations of hemorrhage arteriography were thickening, branching, disorder and neovascularization. 3 patients underwent pulmonary lobectomy after embolization and hemostasis. All patients were followed up for 1 year without recurrent hemoptysis. Conclusion the brachial approach can be used as a good supplementary technique for patients with severe hemoptysis who are suspected to have ITA hemorrhage but who are difficult to select via femoral artery approach.
【作者單位】： 哈爾濱醫(yī)科大學(xué)第二附屬醫(yī)院介入科;
【分類號(hào)】：R459.7

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