血管内栓塞术治疗儿童体动脉源性咯血的临床应用

目的 探讨血管内栓塞术（EVE）治疗儿童体动脉源性咯血的临床应用。方法 纳入2016年1月至2017年11月进行EVE治疗的20例体动脉源性咯血患儿，分析咯血的栓塞方法和疗效。结果 14例责任血管为支气管动脉（BA），1例为非支气管性体动脉（NBSA），5例为BA和NBSA。13例使用末梢栓塞剂、7例使用弹簧圈进行栓塞，共栓塞责任血管41支（BA 34支，NBSA 7支），均获得即刻止血。2例术后6个月内复发，2例术后6~24个月复发。末梢栓塞剂组的整体复发率（1/13，8%）低于弹簧圈组（3/7，43%），但差异无统计学意义（P=0.10）。1例术后发生颅内异位栓塞，经治疗后目前随访20个月生活质量未受影响；无其他并发症发生。结论 EVE治疗儿童体动脉源性咯血是一种安全有效的方法，值得推广应用。

Clinical effect of endovascular embolization in treatment of hemoptysis of systemic arterial origin in children

Objective To investigate the clinical effect of endovascular embolization (EVE) in the treatment of hemoptysis of systemic arterial origin in children. Methods A total of 20 children with hemoptysis of systemic arterial origin who underwent EVE from January 2016 to November 2017 were enrolled. The method for embolization was analyzed and the clinical outcome was evaluated. Results Offending vessels were bronchial artery (BA) in 14 children, non-bronchial systemic artery (NBSA) in 1 child, and BA and NBSA in 5 children. Of all the children, 13 underwent EVE with peripheral embolization agents and 7 underwent EVE with mechanical coils. A total of 41 offending vessels were embolized (34 BAs and 7 NBSAs) and all the children achieved immediate arrest of hemoptysis. Two children experienced recurrence within 6 months after EVE and 2 experienced recurrence with 6-24 months after EVE. The peripheral embolization agent group had a lower overall recurrence rate than the mechanical coil group8% (1/13) vs 43% (3/7); P=0.10]. One child experienced intracranial ectopic embolism after surgery and had good quality of life during 20 months of follow-up after treatment. No other complications were observed. Conclusions EVE is a safe and effective method for the treatment of hemoptysis of systemic arterial origin in children and thus holds promise for clinical application.