支气管动脉的血管解剖及其在大咯血介入治疗中的价值

目的探讨支气管动脉的血管解剖及其在大咯血介入治疗中的价值。方法回顾性总结2004年1月～2011年12月107例大咯血患者行支气管动脉造影(bronchial arteriography,BAG)的DSA造影及胸部多层螺旋CT血管成像(multrslice computed tomographic angiography,MSCTA)资料。结果①支气管动脉大多开口在胸主动脉平T5～T6椎体之间水平(81.3%,87/107)。②10例(9.3%)支气管动脉开口于T5～T6椎体区间以外,称为迷走支气管动脉。③右侧支气管动脉大多与右侧肋间动脉共干,称为肋间-支气管动脉干(intercostobronchial trunk,ICBT)。④起源于胸主动脉的右侧支气管动脉开口于右侧壁及前壁的最多,起源于胸主动脉的左侧支气管动脉开口于前壁的居多。起自胸主动脉的支气管动脉与胸主动脉的下夹角多为锐角。⑤行MSCTA患者中100%可显示双肺内确切病灶,96.3%(52/54)可显示粗大迂曲的支气管动脉。结论支气管动脉栓塞(bronchial artery embolization,BAE)是大咯血安全、有效的治疗手段,已作为内科治疗无效后的首选。了解熟悉支气管动脉的解剖,为介入手术提供可视化解剖基础,从而为介入手术的成功提供重要保证。

Study on anatomy of bronchial arteries and itsimportance for interventional radiology

Objective To study on anatomy of bronchial arteries and itsimportance for interventional radiology.Methods The clinical data(DSA and MSCTA) of 107 cases of bronchial artery embolization were reviewed.Results ①The starting points of bronchial arteries were mainly at the range from T5 to T6(81.3%,87/107).②10(9.3%)branchial arteries with variations in their origination were found.③ The right bronchial arteries were mainly originized from the right posterior intercostal artery,they were named intercostobronchial trunk.④The right bronchial arteries of the descending aorta were mainly arised from the right wall and anterior wall,while the left bronchial arteries of the descending aorta and common trunks arised from the anterior wall of the aorta.⑤The anomalous origin of the bronchial artery could be clearly displayed by MSCTA.Conclusion bronchial artery embolization is a safe and effective method in the treatment of severe hempotysis And it is the best way while other therapies show no effect.Anatomy of Bronchial Arteries provide anatomic data for clinical treatment of hempotysis.