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[血管内栓塞术治疗儿童体循环动脉源性咯血的临床疗效]

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

作者信息

Zhao Qu-Ming, Liu Fang, Wu Lin, Zhao Lu, He Lan, Lu Ying, Wang Li-Bo

机构信息

Pediatric Heart Center, Children's Hospital of Fudan University, Shanghai 201102, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2018 Oct;20(10):809-813. doi: 10.7499/j.issn.1008-8830.2018.10.005.

Abstract

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 group [8%(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.

摘要

目的

探讨血管内栓塞术(EVE)治疗儿童体循环动脉源性咯血的临床效果。

方法

纳入2016年1月至2017年11月期间接受EVE治疗的20例儿童体循环动脉源性咯血患者。分析栓塞方法并评估临床疗效。

结果

14例患儿的责任血管为支气管动脉(BA),1例为非支气管体循环动脉(NBSA),5例为BA和NBSA。所有患儿中,13例行外周栓塞剂EVE,7例行机械弹簧圈EVE。共栓塞41条责任血管(34条BA和7条NBSA),所有患儿咯血均立即停止。2例患儿在EVE后6个月内复发,2例在EVE后6 - 24个月复发。外周栓塞剂组的总体复发率低于机械弹簧圈组[8%(1/13)对43%(3/7);P = 0.10]。1例患儿术后发生颅内异位栓塞,治疗后随访20个月生活质量良好。未观察到其他并发症。

结论

EVE是治疗儿童体循环动脉源性咯血的一种安全有效的方法,具有临床应用前景。

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