支气管扩张咯血DSA表现及栓塞治疗

目的 探讨支气管扩张咯血的DSA表现，评价支气管动脉栓塞疗效及影响因素。方法 21例咯血患者，发作时咯血量150～800 mL，平均410 mL。选择支气管动脉造影明确咯血病灶，使用明胶海绵颗粒或PVA、丝线行栓塞术。结果 DSA造影表现出血直接征像5例，间接征像21例，两肺均有病变16例，一例病变5例，栓塞术后即时止血率90.48％，近期复发率4．76％，中、远期复发率7．14％，并发症发生率4.76％，对症治疗后缓解。结论 DSA造影间接征像比直接征象更常见，更具有诊断价值。支气管动脉栓塞是支扩咯血非常有效的治疗方法。

Bronchiectasis Associated With Hemoptysis:the DSA Manifestation and Embolization Therapy

Objective To study the findings of hemoptysis caused by bronchiectasis in digital subtraction an giography (DSA) and evaluate the healing effects and influence factors of bronchal artery embolization. Methods 21 cases with hemoptysis (the volume of hemoptysis range from 150 to 800 mL, mean 410 mL) were performed DSA and treated by bronchial artery embolization with gelfoam particles, PVA or silk segments. Results 5 cases show direct signs and 21 cases show indirect signs in DSA. Bilateral lungs with lesions appeared in 16 cases and U nilateral in 5 cases. The rate of immediate hemostasis was 90.47 %. The rate of recent and middle - long time recurrent were 5.26% and 6.25 % respectively. The rate of complication was 4.76% and remission were got by treatment. Conclusion The indirect signs of DSA are more important than direct signs. Bronchial artery embolization is an effective technique to treat hemoptysis caused by bronchialectasis.