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[原发性蔓状血管瘤伴大量咯血行支气管动脉栓塞术成功一例]

[A case of successful bronchial artery embolization for primary racemose hemangioma with massive hemoptysis].

作者信息

Narato Ritsuko, Enomoto Tatsuji, Ono Hiroshi, Baba Kumiko, Komazaki Yoshitoshi, Uemura Natsu, Saito Hitoshi, Shibuya Yasuhiro, Yokosuka Tetsuya, Kobayashi Toshiko, Nakamura Seiichi

机构信息

Department of Respiratory Medicine, Tokyo Metropolitan Hiroo General Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2006 Sep;44(9):641-6.

Abstract

We encountered a case of primary racemose hemangioma treatment with successful bronchial artery embolism for massive hemoptysis. A 56-year-old woman with massive hemoptysis was transported to our hospital. The source of the massive hemoptysis was observed to be from around a non-pulsatile polyp covered by normal mucosa occluding the truncus intermedius by fiberoptic bronchoscopy. We stopped the bleeding temporarily using differential lung ventilation, and then bronchial artery angiography was performed. The main right bronchial artery was enlarged, and enlarged and convoluted right peripheral bronchial vessels were also observed. We diagnosed the massive bleeding to be due to racemose hemangioma. A successful bronchial artery embolization (BAE) was performed with gelforms and metallic coils for the treatment of racemose hemangioma. There has been no recurrence of hemoptysis for one year after BAE. There have been many reports on massive hemoptysis as in this patient who were treated by lobectomy, nevertheless we would like to state BAE should be considered as a suitable treatments for primary racemose hemangioma with hemoptysis if there is no recognizable shunt artery.

摘要

我们遇到了一例原发性蔓状血管瘤,通过支气管动脉栓塞术成功治疗了大量咯血。一名因大量咯血的56岁女性被送往我院。通过纤维支气管镜观察到大量咯血的来源是一个被正常黏膜覆盖的无搏动性息肉,该息肉阻塞了中间段支气管。我们使用肺区别通气暂时止住了出血,然后进行了支气管动脉造影。右主支气管动脉增粗,还观察到右肺外周支气管血管增粗且迂曲。我们诊断大量出血是由于蔓状血管瘤所致。采用明胶海绵和金属线圈成功进行了支气管动脉栓塞术(BAE)以治疗蔓状血管瘤。BAE术后一年咯血未复发。对于像该患者这样因大量咯血而接受肺叶切除术治疗的情况已有很多报道,然而我们想说,如果没有可识别的分流动脉,BAE应被视为原发性蔓状血管瘤伴咯血的一种合适治疗方法。

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