维吾尔族与汉族咯血患者支气管动脉多层螺旋CT影像解剖学对比研究

目的 探讨维吾尔族与汉族咯血患者支气管动脉多层螺旋CT 血管成像(MSCTA)影像解剖学差异。方法 回顾性分析喀什地区第一人民医院2016年1月—2017年12月70例维吾尔族咯血患者(维吾尔族组)和70例汉族咯血患者(汉族组)行支气管动脉MSCTA检查,运用多平面重组(MPR)、最大密度投影(MIP)和三维容积重现(VR)等后处理技术显示和观察两组患者支气管动脉的起源、开口位置、分布类型、分型。结果 140例患者CTA显示支气管动脉共371支,其中原位208支(56.06%),异位163支(43.94%);其中70例维吾尔族患者原位支气管动脉占50.84%(90/177)、异位49.16%支(87/177),70例汉族患者原位支气管动脉占60.82%(118/194)、异位39.18%(76 /194),两组比较差异无统计学意义(χ²=3.740, P＞0.05)。两组患者异位支气管起源于主动脉弓、肋间动脉的占比比较差异有统计学意义(χ²=9.861、4.415, P值均＜0.05),原位支气管动脉开口位于降主动脉前、后、左、右侧壁位置组间比较差异有统计学意义(χ²=19.763, P＜0.01)。两组患者支气管动脉发育分型均以Ⅱ型多见,维吾尔族组患者占49.63%(66/133),汉族患者占55.64%(74/133),其次维吾尔族人以Ⅰ型(27.07%、36/133)和Ⅳ型(14.28%、19/133)多见,汉族以Ⅰ型(19.55%、26/133)和Ⅲ型(19.55%、26/133)为主,差异有统计学意义(χ²=12.766, P＜0.01)。结论 支气管动脉系统发育个体差异较大,维吾尔族与汉族咯血患者的支气管动脉起源、开口方位及分型,均存在一定的差异;在支气管动脉栓塞术前行支气管动脉CTA,可为介入治疗提供详尽的三维影像解剖信息,对快速选择责任血管,避免反复插管以缩短造影时间,均有一定指导意义。     

明胶海绵在肺结核咯血动脉栓塞中的应用

背景：目前国内用于支气管动脉栓塞的栓塞剂材料主要有明胶海绵、PVA颗粒、藻酸钠微球、弹簧圈等。 目的：分析总结明胶海绵应用于动脉栓塞治疗肺咯血治疗效果。 方法：以“肺咯血、栓塞、肺结核、明胶海绵”为中文关键词,以：“Hemoptysis 、Embolization 、Tuberculosis、 Gelfoam” 为英文关键词,采用计算机检索中国期刊全文数据库、维普数据库(1995-01/2011-05)相关文章。纳入明胶海绵栓塞法治疗肺结核咯血等相关的文章,排除重复研究或Meta分析类文章。 结果与结论：共入选17篇文章进入结果分析。综述了明胶海绵在肺结核咯血动脉栓塞中的应用。包括明胶海绵栓塞剂的介绍,动脉栓塞术止血技术以及用明胶海绵动脉栓塞治疗肺咯血治疗效果及不足等方面的研究内容。高压高温处理后的明胶海绵作为栓塞剂治疗肺咯血,不仅临床疗效满意而且非常经济,适合目前中国的国情。     

儿童先天性体动脉-肺动脉瘘4例并文献复习

目的总结临床表现为大量咯血的先天性体动脉-肺动脉瘘患儿的临床特点及诊治经验。方法回顾性收集首都医科大学附属北京儿童医院2007年3月至2008年2月诊断为先天性体动脉-肺动脉瘘4例患儿的临床资料,总结其临床表现、胸部X线片、胸部64排CT增强扫描三维容积再现（3D-VR）、数字减影血管造影（DSA）、治疗及随访情况。结果男1例,女3例,最大发病年龄为11岁,最小发病年龄为2个月,主要表现为咯血。1例有杵状指,3例未见特异性体征。胸部X线片检查：3例未见异常,1例示肺间实质浸润。胸部64排CT增强扫描3D-VR检查：1例提示支气管动脉迂曲,但未见异常交通;1例导管栓塞治疗（TCE）后示右侧支气管动脉扩张迂曲,并与肺动脉相通可能性大,考虑支气管动脉-肺动脉瘘;1例提示支气管动脉-肺动脉瘘;1例未见异常。3例DSA提示为支气管动脉-肺动脉瘘,病变部位均位于右下肺,并行TCE。随访至2009年2～5月,1例复发,表现为痰中带血,胸部64排CT增强扫描未见异常,余3例未复发。3例怀疑为遗传性出血性毛细血管扩张症（HHT）,1例考虑为HHT高度危险者。结论体动脉-肺动脉瘘可造成大量咯血。胸部X线片一般无特异性表现,胸部64排CT增强扫描3D-VR可显示病变部位,明确诊断需行DSA。可采用TCE治疗。TCE远期效果应进行长期随访予以明确。     

海藻酸钠微球支气管动脉栓塞材料治疗肺结核大咯血的有效性

背景：临床对肺结核大咯血患者实施支气管动脉栓塞介入治疗过程中,可以选择不同的栓塞材料,其中海藻酸钠微球和明胶海绵是两种常用的材料,但目前关于两种材料应用效果的比较分析相关报道相对较少。目的：分析海藻酸钠微球支气管动脉栓塞治疗肺结核大咯血的临床有效性。方法：纳入157例肺结核大咯血患者,其中男98例,女59例,年龄22-75岁,均实施支气管动脉栓塞治疗,按照栓塞材料的不同分为海藻酸钠微球组(n=74)和明胶海绵组(n=83)。栓塞治疗后随访12个月,观察两组临床疗效、复发情况及并发症发生情况。结果与结论：经疗效判定,海藻酸钠微球组和明胶海绵组的治疗总有效率分别为91.2%和81.9%,组间治疗总有效率比较差异有显著性意义(P < 0.05); 海藻酸钠微球组和明胶海绵组的复发率分别为6.8%和26.5%,组间复发率比较差异有显著性意义(P < 0.05);两组并发症发生情况比较差异无显著性意义(P > 0.05)。表明海藻酸钠微球支气管动脉栓塞治疗肺结核大咯血临床有效率高、复发率低,效果更理想。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

剖宫产瘢痕妊娠病灶切除术与子宫动脉栓塞术后 清宫的效果比较

目的 比较剖宫产瘢痕妊娠病（CSP）灶切除与子宫动脉栓塞后清宫的临床效果。方法 回顾性分析2015年1月~2018年6月我院收治的110例剖宫产瘢痕妊娠患者的临床资料,根据手术方式分为手术组（52例）和清宫组（58例）,手术组行瘢痕病灶切除术,清宫组同期行子宫动脉栓塞后清宫,比较两组术中出血量、血HCG下降至正常的时间、住院费用及术后第1次月经量改变情况。结果 手术组平均出血量为（80.59±17.12）ml,高于清宫组的（8.65±1.53）ml,差异有统计学意义（P＜0.05）;手术组血HCG下降至正常时间为（22.40±7.45）d,少于清宫组的（31.80±8.24）d,差异有统计学意义（P＜0.05）;两组住院费用比较,差异无统计学意义（P＞0.05）;清宫组有9例出现术后第1次月经量减少,手术组无患者发生月经量改变。结论 瘢痕妊娠病灶切除与子宫动脉栓塞后清宫的住院费用相当,但子宫动脉栓塞后清宫有瘢痕持续存在、术后血HCG下降缓慢、部分患者出现月经量减少的缺点,故对于肌壁厚度＜4 mm,有再生育要求的CSP患者,瘢痕病灶切除术应作为首选的治疗措施。     

子宫动脉栓塞联合宫腔镜治疗子宫切口妊娠的疗效分析

目的 分析子宫动脉栓塞联合宫腔镜治疗子宫切口妊娠的临床疗效。方法 选取50例汉川市第二人民医院2015年9月~2017年5月收治的子宫切口妊娠患者,通过随机方式将其分为常规组和联合组,各25例,给予常规组患者肌注氨甲蝶呤及B超检测下清宫术治疗,给予联合组患者子宫动脉栓塞联合宫腔镜下清宫术治疗,观察两组患者术中各指标水平,不良反应发生情况。结果 联合组患者各手术指标术中出血、阴道流血时间、血β-HCG转阴时间水平均低于常规组患者,差异有统计学意义（P＜0.05）;联合组患者不良反应发生率低于常规组患者,差异有统计学意义（P＜0.05）。结论 子宫动脉栓塞联合宫腔镜治疗子宫切口妊娠的临床疗效显著,能有效降低术中出血量,加快患者术后恢复,且具有较高的安全性,临床价值较高。     

影响PCNL术后出血栓塞治疗的主要因素分析

目的 探讨决定经皮肾镜取石术（PCNL）后出血是否行栓塞治疗的因素。方法 回顾性分析我院2013年6月~2017年11月经皮肾镜术后出血患者共52例,根据术后止血方式分为保守治疗组40例和栓塞组12例。保守治疗组经保守治疗后出血停止,栓塞组选择肾动脉栓塞后止血成功。对两组患者的人口学资料、结石类型、手术相关因素及出血相关因素进行单变量分析,将栓塞治疗相关因素纳入多变量Logistic回归进一步分析。结果 两组患者的人口学资料、结石类型、手术相关因素、术前血红蛋白水平、出血天数、输血量比较,差异无统计学意义（P＞0.05）。栓塞组Hb下降值大于保守治疗组[（44.08±11.86）g/L vs （19.05±12.72）g/L],输血比例高于保守治疗组（8/12 vs 6/40）,差异具有统计学意义（P＜0.05）。多变量Logistic回归分析结果显示,Hb下降值为决定PCNL术后出血是否栓塞的重要因素（OR=1.142,95%CI 1.038~1.256,P=0.006）。结论 Hb下降值为决定PCNL术后出血患者栓塞治疗的重要因素,在决定是否行栓塞治疗时应充分考虑Hb下降的程度。     

经皮肺穿刺与支气管镜活检对周围性肺癌的诊断价值

目的 对比经皮肺穿刺与支气管镜活检对周围性肺癌的诊断价值。方法 选取2014年6月~2018年7月我院就诊的69例可疑周围肺癌患者,将其随机分为两组,其中皮肺穿刺组30例,支气管镜活检组39例。比较两组患者阳性诊断率、病理诊断符合率、敏感度、特异度及并发症发生情况。结果 支气管镜活检组患者病理阳性诊断率79.48%高于皮肺穿刺组63.33%,差异有统计学意义（P＜0.05）。支气管镜活检组患者病理诊断符合率、灵敏度、特异度分别为92.31%、91.18%、100%高于皮肺穿刺的72.41%、80.95%、66.67%,差异有统计学意义（P＜0.05）。支气管镜活检组患者术后穿刺部位出血5例,气胸1例,咳血3例;皮肺穿刺组术后穿刺部位出血7例,咳血4例,气胸8例,两组间相比,差异有统计学意义（P＜0.05）。结论 在诊断周围性肺癌支气管镜活检比皮肺穿刺诊断效果更好、并发症发生率低,在临床应用时可优先考虑。     

Longterm histopathologic follow-up of bronchial arteries after therapeutic embolization with polyvinyl alcohol (Ivalon) in patients with cystic fibrosis

We used light microscopy to examine, at autopsy, bronchial arteries in three patients with cystic fibrosis who died, respectively, 10, 16, and 28 months after bronchial artery embolization with barium sulfate-impregnated polyvinyl alcohol (PVA) to control hemoptysis. PVA was not identified beyond the midsegmental bronchus in any patient. Persistent focal fibrovascular occlusion was noted in two patients, and recanalized and/or partially obstructed vessels were associated with PVA in all. The histologic reaction to PVA included fibrosis, mild chronic inflammation, localized foreign body reaction, and, in two patients, focal calcification of PVA spicules. Within the inflammatory milieu were numerous macrophages containing BaSO4. Extensive vascular mural destruction and fibrosis associated with PVA were also observed. Both PVA and BaSO4 were also frequently present in the perivascular connective tissue. These findings indicate that, although longterm occlusion persists after therapeutic arterial embolization with PVA, focal recanalization also occurs. The extent of vascular mural injury following PVA embolization in humans has been previously underestimated by animal experiments. Finally, perivascular deposition of PVA represents a common reaction to diverse foreign body emboli in both systemic and pulmonary arteries.     

子宫动脉栓塞术联合宫腔镜治疗 子宫黏膜下大肌瘤的效果

目的 探讨子宫黏膜下大肌瘤实施子宫动脉栓塞联合宫腔镜治疗的临床效果。方法 选择我院2017年1月~2018年7月收治的60例子宫黏膜下大肌瘤患者,随机分为宫腔镜组和联合组,各30例。宫腔镜组患者运用宫腔镜电切治疗,联合组在此基础上联合子宫动脉栓塞治疗,比较两组宫腔镜手术时间、术中出血量、术后排气时间、治疗总有效率、术后并发症情况及术后3个月血红蛋白、月经量、月经时间变化情况。结果 联合组宫腔镜手术时间、术中出血量、术后排气时间及术后并发症发生率分别为（52.23±5.67）min、（32.29±5.38）ml、（12.83±2.18）h、6.67%,均低于宫腔镜组的（72.44±6.54）min、（75.46±4.53）ml、（22.15±4.23）h、26.67%,差异有统计学意义（P＜0.05）;联合组治疗总有效率为96.67%,高于宫腔镜组的80.00%,差异有统计学意义（P＜0.05）;联合组术后3个月血红蛋白水平高于宫腔镜组,差异有统计学意义（P＜0.05）;联合组月经量、月经时间低于宫腔镜组,差异有统计学意义（P＜0.05）。结论 子宫黏膜下大肌瘤实施子宫动脉栓塞联合宫腔镜治疗效果好,且可有效减轻手术创伤,降低术后并发症风险,促进患者术后恢复。     

CalliSpheres载药微球子宫动脉栓塞术治疗宫颈癌的疗效评价

目的　评价CalliSpheres载药微球子宫动脉栓塞术治疗局部晚期宫颈癌疗效。 方法　选取2016年2月至2018年9月本介入科收治的宫颈癌患者48例（平均年龄49岁）,采用随机数字分配法将患者分为普通微球子宫动脉栓塞+表阿霉素子宫动脉灌注化疗组24例（A组）,表阿霉素载药微球子宫动脉栓塞化疗组24例（B组）。每组治疗2个周期,间隔3周。记录出血减少情况,以CT评价肿瘤大小变化,分析骨髓抑制及消化道反应。 结果　（1）两组患者阴道出血均减少;普通微球组术后出血持续时间为（6±1.5）d,载药微球组为（3± 0.8）d,差异有统计学意义,P<0.01。（2）肿瘤缩小率：普通微球组客观缓解率为83.8%,载药微球组为95.8%,差异有统计学意义,P<0.01。（3）副反应：两组患者均出现腹痛,VAS评分普通微球组（8±2）分,载药微球组（3±1）分,差异有统计学意义,P<0.01;骨髓抑制仅发生于普通微球组。 结论　CalliSpheres载药微球治疗宫颈癌较传统的化疗栓塞术具有更高的肿瘤缩小率,术后阴道出血时间更短,无骨髓抑制且腹痛可控。     

The potential role of inflammation in cryptogenic stroke

PurposeThe study aimed to identify biomarkers predictive of cryptogenic stroke in patients aged <65.Materials and methodsWe investigated 520 patients with ischemic stroke. Out of them we assigned 65 patients to the cryptogenic stroke group (age 54 (47–58), 42% male) and 36 without stroke to the control group (age 53 (47–58), 61% male). In all patients we assessed carotid intima-media thickness (cIMT) and the levels of biomarkers which might be involved in the underlying biological mechanism of ischemic stroke.ResultsThere were no differences between stroke and control groups in the levels of syndecan 4, resistin, leptin, low-density lipoprotein cholesterol, triglycerides, prothrombin time, or activated partial thromboplastin time. There was no statistically significant difference in cIMT between groups. The level of high-density lipoprotein cholesterol was statistically significantly lower in the cryptogenic stroke group than in the controls (1.1 mmol/L (0.95–1.46) vs 1.37 (1.19–1.6) p = 0.02). Patients in the stroke group had higher levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) (391 pg/ml (107–1249) vs 109 (46–236); p = 0.003), interleukin 6 (2.6 pg/ml (0.8–8.1) vs 0.7 (0.4–1.2) p = 0.002) and asymmetric dimethylarginine (ADMA) (0.44 μmol/L (0.39-0.55) vs 0.36 (0.32-0.4); p = 0.0002) than the control group. In the multivariate analysis Il-6 was the only biomarker statistically significant associated with the occurrence of cryptogenic stroke (odds ratio 1.918, 95% confidence interval 1.029–3.575; p = 0.04).ConclusionsEndothelial dysfunction assessed by increased level of ADMA affects the inflammatory state in patients with cryptogenic stroke. Increase in the inflammatory cytokine IL-6 by 1 pg/ml almost doubles the risk of stroke.     

The effectiveness of embolotherapy for treatment of hemoptysis in patients with varying severity of tuberculosis by assessment of chest radiography

The effectiveness of percutaneous embolotherapy in cases of hemoptysis due to pulmonary tuberculosis from increasing severity of lung parenchymal injury was compared. The pattern of pleural involvement, as seen on chest radiography and angiography, were comparatively analyzed in 230 patients who were available for follow-ups from March 1992 to December 2003. Chest radiography findings were classified into 4 types based on levels of complicated lesions and pleural involvement. Angiography findings were divided into 4 groups based on the level of blood supply to lesions. Early hemostasis with respect to radiographic group were as follows: Type I- 92% (73/79), Type II- 80% (52/65), Type III- 70% (42/60), and Type IV- 56% (52/92); there was an average success rate of 73% (219/296), and continued hemostasis was found in 80% of Type I patients (62/77), 77% of Type II patients (41/53), 62% of Type III patients (25/40), and 45% of Type IV patients (27/60), with an average long- term hemostatic rate of 67% (155/230). Increasing severity of pleural involvement and associated complications correlated with increasing development of systemic collateral arteries other than the bronchial artery. The severely increased circulation in systemic collateral arteries makes it difficult to predict good hemostatic results following embolization. Therefore, we recommend aggressive treatment, such as surgical intervention, after embolization in such instances.     

Endobronchial Stent Insertion to Manage Hemoptysis caused by Lung Cancer

Hemoptysis in patients with lung cancer is not uncommon and sometimes have dangerous consequences. Hemoptysis has been managed with various treatment options other than surgery and medicine, such as endobronchial tamponade, transcatheter arterial embolization and radiation therapy. However, these methods can sometimes be used only temporarily or are not suitable for a patient''s condition. We present a case in which uncontrollable hemoptysis caused by central lung cancer was successfully treated by inserting a covered self-expanding bronchial stent. The patient could be extubated and was able to undergo further palliative therapy. No recurrent episodes of hemoptysis occurred for the following three months. As our case, airway stenting is a considerable option for the tamponade of a bleeding lesion that cannot be successfully managed with other treatment methods and could be used to preserve airway patency in a select group of patients.     

The porcine bronchial artery. Anastomoses with oesophageal, coronary and intercostal arteries

Information abut the existence and anatomy of arterial anastomoses with the porcine bronchial artery is lacking in the literature. Prior to basic physiological investigations in a porcine model related to lung transplantation with bronchial artery revascularisation, this study was designed to examine the anatomy of systemic arterial anastomoses with the bronchial artery system. Twenty pigs were studied in 3 groups. In 2 groups the heart–lung block was removed with all mediastinal structures. One group served for investigation of coronary–bronchial artery anastomoses and one for investigation of oesophageal–bronchial artery anastomoses. The systemic arteries to be examined were cannulated. The inflated heart–lung block was examined macroscopically with Evans blue, and radiographically after contrast injection. In the 3rd group intercostobronchial artery anastomoses were studied radiographically with the heart–lung block in situ. Coronary–bronchial artery anastomoses were demonstrated in 3 of the 5 pigs with an aortic 'pouch' technique, but contrast was very limited in 2 of these 3. Oesophageal arterial anastomoses with bronchial arterial branches and/or the pulmonary veins were demonstrated in 6 of the 7 pigs and more markedly than the coronary–bronchial anastomoses. Intercostobronchial artery anastomoses could not be demonstrated angiographically. It was concluded that the existence of coronary–bronchial and oesophageal–bronchial artery anastomoses in the pig appear to establish an arterial net between the base of the heart and the distal oesophagus. The resemblance to human oesophageal–bronchial artery anastomoses supports use of a porcine model for experimental studies.     

孟鲁司特治疗支气管哮喘的临床研究

目的 分析孟鲁司特对支气管哮喘患者的治疗效果及影响,为临床提供参考。方法 选取2016年1月~2017年1月我院收治的90例支气管哮喘患者,以随机数表法分成观察组与对照组,各45例。对照组予以常规治疗,观察组在常规治疗基础上加用孟鲁司特钠治疗,对比观察两组患者治疗总有效率、临床症状评分及不良反应情况。结果 观察组患者临床治疗总有效率94.33%,高于对照组77.78%,差异有统计学意义（P＜0.05）;观察组临床症状评分（0.71±0.23）分,低于对照组（1.67±0.26）分,差异有统计学意义（P＜0.05）。观察组不良反应率4.40%与对照组6.60%对比,差异无统计学意义（P＞0.05）。结论 孟鲁司特对支气管哮喘患者的治疗效果显著,与常规治疗相比,其不仅可有效提高临床疗效,而且可有效减少不良反应发生率,值得临床推广。     

选择性脾动脉栓塞术对急诊外伤性脾破裂救治的效果探讨

目的探讨在急诊外伤性脾破裂的救治中实施选择性脾动脉栓塞术(PSAE)的效果。方法选择2015年3月至2019年8月收治的86例外伤性脾破裂患者,根据患者的意愿分为修补组(n=43)和栓塞组(n=43),修补组实施脾修补术,栓塞组实施PSAE。比较2组患者手术时间、术中出血量、下床时间、住院时间、T淋巴细胞水平及并发症发生情况。结果栓塞组患者手术时间、下床时间及住院时间均短于修补组(P=0.002、0.012、0.007),术中出血量少于修补组(P=0.000);治疗14 d后栓塞组CD3+、CD4+、CD4/CD8+水平高于修补组(P=0.023、0.018、0.011),CD8+水平低于修补组(P=0.015)。栓塞组共有3例患者(6.98%)发生并发症,而修补组有10例(23.26%)发生并发症,2组比较差异有统计学意义(P<0.05)。结论PSAE应用于急诊外伤性脾破裂效果良好,可缩短手术至康复所需时间,同时起到改善免疫功能的作用。     

两种手术方式治疗膝下动脉闭塞性病变的临床疗效对比

目的探讨腔内血管成形术与下肢动脉旁路移植术治疗膝下动脉闭塞性病变的临床疗效。方法选取膝下动脉闭塞性病变患者343例作为研究对象,其中142例行下肢动脉旁路移植术(旁路移植组),201例行腔内血管成形术(血管成形组)。采用1∶1倾向性评分,以血管成形组为基准组进行匹配,共67例匹配成功。分析2组肢体挽救率、靶血管一期通畅率、踝肱指数(ABI)、Rutherford分级评分及并发症发生情况。结果2组肢体挽救率、靶血管一期通畅率比较,差异均无统计学意义(P>0.05)。2组术前ABI、Rutherford分级评分比较,差异无统计学意义(P>0.05);但重复测量结果显示,以时间因素为作用主效应差异有统计学意义(P<0.05);2组术后7 d、6个月ABI均高于术前(P<0.05),但同一时间点组间比较差异无统计学意义(P>0.05);2组术后7 d、6个月Rutherford分级评分均低于术前(P<0.05),但同一时间点组间比较差异无统计学意义(P>0.05)。血管成形组并发症发生率明显低于旁路移植组(P<0.05)。结论腔内血管成形术与下肢动脉旁路移植术治疗膝下动脉闭塞性病变,患者的肢体挽救率、靶血管一期通畅率相当,但腔内血管成形术并发症相对较少。     

The porcine bronchial artery: surgical and angiographic anatomy

The pig is often used in experimental studies on the significance of bronchial artery circulation, but the anatomy of this artery is only poorly described. The purpose of this study was to improve the anatomical basis for experimental studies on the porcine bronchial artery circulation. The origin of the artery from the aorta is described in 32 pigs. Heart–lung blocks were perfused with saline and removed in 16 pigs, and the broncho-oesophageal orifice was identified and cannulated. In these 16 specimens the intrapulmonary ramification was studied by angiography, and the extrapulmonary distribution and supply area by injection of Evans Blue. The broncho-oesophageal artery originated from the aorta as a single trunk in 91%. Angiography showed that each principal bronchus was accompanied by 2 bronchial artery branches far into the lung parenchyma. The central branching pattern of the artery between the aorta and the principal bronchi was divided into 3 subtypes. Evans Blue showed communication with the whole mediastinum. The anatomical relations are described. It is concluded that the broncho-oesophageal artery divides to follow each bronchus with 2 bronchial branches. A nomenclature for these branches is suggested. The pig anatomy is suited for experimental investigations on the bronchial circulation.     

超声引导对经皮肝胃冠状静脉栓塞术的辅助作用

目的探讨超声引导对经皮肝胃冠状静脉栓塞术（PTVE）治疗肝硬化上消化道出血的辅助作用。方法52例经超声引导下PrrVE作为观察组,37例采用盲穿门静脉行PTVE作为对照组。比较2组患者穿刺成功率、穿刺时间（指确定穿刺点至导管置入时间）、栓塞效果及并发症发生率。结果观察组1次穿刺成功率（73．1％）显著高于对照组（43．2％）,P〈0．05具有统计学意义。观察组1次穿刺成功时间（2．3±0．6）min显著低于对照组（4．2±0．8）min,P〈0．05具有统计学意义。观察组栓塞成功率（100％）显著高于对照组（86．5％）,P〈0．05具有统计学意义。观察组并发症发生率低于对照组。结论超声引导对PTVE具有重要的辅助作用,能准确判断门静脉位置,增加了穿刺成功率,提高了穿刺速度。