介入封堵治疗13例儿童咯血疗效观察
DOI:
CSTR:
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

基金项目:


Clinical observation of interventional treatment by occluders in 13 children with hemoptysis
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:总结分析13例经介入封堵治疗咯血患儿的临床特点,提高对本病的认识。方法:回顾性分析13例经介入诊疗儿童咯血临床表现、实验室检查、影像学特点、治疗等情况。结果:13例患儿共行介入数字减影血管成像(digital subtraction an-giography,DSA)检查21例次、动脉栓塞治疗14例次。临床表现大量咯血4例,中-少量咯血9例,合并肺炎10例,含铁血黄素巨噬细胞阳性7例,贫血9例,介入诊疗前心脏彩超检出侧枝血管形成5例,CT血管造影(computed tomography angiography,CTA)检出9例。心导管DSA检查总共发现畸形肺血管32支,其中支气管动脉异位起源25支(25/32,78.125%),另有7支(7/32,21.875%)系体循环来源的非支气管动脉。治疗上给予止血、吸氧、维持通气、纠正贫血等常规治疗,经支气管动脉栓塞(bronchial artery embolization,BAE)治疗14例次,术后3 d内均停止咯血,造影剂纵隔渗漏2例、胸痛4例、股动脉血栓1例。 结论:对于怀疑血管畸形所致的儿童咯血患儿,心脏彩超联合心脏CT及血管重建检查具有筛查意义,DSA检查是其诊断金标准,利用封堵器栓塞畸形动脉止血效果良好、安全可靠,可推广应用。

    Abstract:

    Objective:To analyze the interventional diagnosis and treatment of 13 children with hemoptysis and to improve the skills of pediatricians in the diagnosis and treatment of hemoptysis in children. Methods:The medical records including clinical manifestations,laboratory results,image data and treatments of 13 pediatric patients with hemoptysis given interventional treatment were retrospec-tively reviewed. Results:In 13 patients,including pneumonia(10 cases) and anaemia(9 cases),digital subtraction angiography(DSA) was performed for 21 times,and artery embolization therapy was performed for 14 times. Siderophages were identified in 7 patients. Four patients had massive hemoptysis,and 9 patients had non-massive hemoptysis. Five patients with collateral vessels were identified by ultrasonic cardiogram before interventional diagnosis,and 9 patients were identified by computed tomography angiography(CTA). Thirty-two abnormal pulmonary vessels were detected by DSA. Twenty-five(78.125%) of them were aberrant bronchial arteries,and seven of (21.875%) them arose from non-bronchial systemic arteries. Conventional treatments,including hemostatic agents,oxygen supplementation,ventilation support and hemoglobin maintaining,were administrated. Fourteen patients required bronchial artery em-bolization(BAE) treatment; the hemoptysis disappeared for all the patients three days after BAE; two of them were detected to have contract leaking to mediastinum,four of them had chest pain,one of them had complication of femoral arterial thrombosis. Conclusion:Echocardiography(UCG) combining CTA plays significant role in screening of pediatric hemoptysis suspecting to be aberrant vessels,and DSA is the golden standard for diagnosis. Occluder em-bolizing aberrant vessels has good effect of hemostasis. Aberrant vessel embolization by occluder has high quality in hemostasis,safety and stability,which is worth popularizing.

    参考文献
    相似文献
    引证文献
引用本文

罗历,易岂建,李谧,吕铁伟,白永虹,计晓娟,蒲晓芳.介入封堵治疗13例儿童咯血疗效观察[J].重庆医科大学学报,2018,(3):353-

复制
分享
相关视频

文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2019-05-30
  • 出版日期:
文章二维码