支气管动脉栓塞术并发症分析

目的　研究支气管动脉栓塞术并发症及其相关因素。方法　 1 61例患者 ,大咯血 2 6例 ,支气管肺癌 1 35例。行选择性支气管动脉插管造影确认病变血供 ,分别在支气管动脉干或支气管动脉分支超选择插管下行栓塞术或栓塞化疗术 ,栓塞物质为明胶海绵颗粒、PVA和碘油。结果　并发症发生率 6 .2 % ,包括脊髓缺血 (1 .2 2 % )、肋间动脉缺血 (3 .7% )、肺动脉栓塞 (1 .2 % )。脊髓缺血和肋间动脉缺血均发生在支气管动脉主干栓塞者。脊髓缺血见于PVA组和碘油组 ,肺动脉栓塞见于碘油组 ,而肋间动脉缺血在各栓塞物质组均有发生。结论　支气管动脉栓塞术宜谨慎施行 ,使用同轴导管技术超选择性插管值得推荐 ,明胶海绵颗粒是相对安全的栓塞物质

Complications of Bronchial Arterial Embolization

Objective To evaluate the complications and its related factors of bronchial arterial embolization.Methods Bronchial arterial embolization was performed in 161 cases,26 of them with hemoptysis and the others with lung cancer.Bronchial artery angiograms were taken to confirm the blood supply of lesions.Embolization or chemoembolization was then performed in bronchial artery or its branches.Embolic agents used were Gelfoam particles,PVA and Lipiodol separately.Results Complications happened in 6.2% cases,consisited of spinal cord injury(1.2%),intercoastal artery ischemia(3.7%),and pulmonary arterial embolization(1.2%).Spinal cord injury and intercoastal symptoms occurred with bronchial artery embolization other than its branches.Spinal cord injury happened in PVA group and Lipiodol group,while pulmonary arterial embolization and intercoastal symptoms were seen in Lipiodol group and in all three groups respectively.Conclusion Transcatheter bronchial arterial embolization should be performed carefully.Super-selective catheterization is the method of choice to avoid potential ischemic complications.Gelfoam particles is a relatively safe embolic agent.