血管内介入治疗对肺部咯血性疾病血供来源的探讨

目的:探讨肺部咯血性疾病供血动脉的来源,提高血管内介入治疗的效果。方法:经血管内介入治疗咯血患者58例,其中支扩27例,肺结核21例,肺癌8例,炎症2例。急性大咯血53例,反复少量咯血5例。全部采取经动脉穿刺插管进行血管造影及栓塞处理。结果:发现供血动脉167条,其中,支气管动脉81条,肋间动脉41条,胸廓内动脉24条,腋动脉分支18条,膈动脉3条;支气管动脉参与供血58例,肋间动脉参与供血35例,胸廓内动脉参与供血者24例,腋动脉分支参与供血者14例,膈动脉参与供血者2例;单纯由支气管动脉供血者21例,合并有其它血管供血者37例。结论:支气管动脉是肺部咯血性疾病的主要供血动脉,血供来源与病变性质无关,邻近病变部位的血管均可发出分支参与供血。

Study of blood supplying in the patients with hemoptysis via angiography

Objective:To investigate the source of blood supplying artery in those diseases with hemoptysis so as to improve the interventional therapeutic efficacy.Methods:Fifty-eight patients with hemoptysis were treated with angiography and embolization,including bronchiectasis(27 cases),pulmonary tuberculosis(21 cases),lung cancer(8 cases) and pneumonia(2 cases).The acute massive hemoptysis were occurred in 53 case,repeated small amount hemoptysis in 5 case.Results:167 pulmonary feeding artery,including 81 bronchial artery,41 intercostals artery,24 internal mammary artery,14 axillary artery branch,3 arteria phrenica were detected.The bronchial artery supplying the pulmonary lesions were found in 58 cases,intercostals artery supplying in 35 cases,internal mammary artery supplying in 24 cases,axillary artery branch supplying in 14 cases,arteria phrenica supplying in 2 cases,simple bronchial artery supplying in 21 cases,incorporated other artery supplying in 37 cases.Conclusion:Bronchial artery is the major blood supplying of pulmonary hemoptysis lesions.The disease vascularity is independent with character of disease.The vicinity blood vessel of diseased region can even evolve into blood supplying branch.