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目的 :探讨急性大咯血的DSA表现 ,观察选择性支气管动脉栓塞术的疗效。方法 :采用Seldinger技术 ,将导管选择性插入支气管动脉 ,注入非离子型对比剂 ,行正位DSA ,确诊后用对比剂稀释消毒的明胶海绵颗粒进行栓塞。结果 :①短期有效率达 10 0 %。 15例随访平均 18个月 ,复发 2例 ,疗效显著 ;②DSA表现 :6例 ( 4 0 % )肺实质内可见对比剂渗出和支气管内对比剂涂抹 ,9例 ( 6 0 % )出现支气管动脉主干扩张、增粗、扭曲 ,支气管动脉与肺血管间形成分流 ;支气管动脉分支增多 ;病变区内充血 ,小血管扩张紊乱呈簇状、索状或团状。结论 :DSA是确诊大咯血的有效方法 ,选择性支气管动脉栓塞对治疗急性大咯血是一种有效、安全、简便的治疗方法
Objective: To investigate the DSA manifestations of acute massive hemoptysis and observe the curative effect of selective bronchial artery embolization. Methods: The Seldinger technique was used to selectively insert the catheter into the bronchial artery. The non-ionic contrast agent was injected into the artery to perform DSA. After the diagnosis, the gelatin sponge particles diluted with contrast agent were embolized. Results: ① short-term effective rate of 100%. 15 cases were followed up for an average of 18 months, 2 cases relapsed, the effect was significant; ② DSA performance: 6 cases (40%) of the lung parenchyma visible contrast agent exudation and bronchial contrast agent smear, 9 cases (60%) bronchial artery Main trunk expansion, thickening, distorting, the bronchial artery and pulmonary vessels shunt; bronchial artery branches increased; lesion area congestion, small vessel dilatation disorders were clustered, cord-like or lumpy. Conclusion: DSA is an effective method for the diagnosis of massive hemoptysis. Selective bronchial artery embolization is an effective, safe and easy treatment for acute massive hemoptysis