Fan Wei, Su Huling, Chang Yaowen, Wang Wenhui
First Clinical College of Lanzhou University, Lanzhou City, Gansu Province, China.
Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China.
Biomed Eng Online. 2024 Aug 7;23(1):79. doi: 10.1186/s12938-024-01270-8.
The abnormal anatomical alterations of blood vessels during DSA angiography in patients with hematological disorders were retrospectively examined, and the influencing factors of short-term (≤ 6 months) recurrent hemoptysis were statistically analyzed, and the consistency between admission diagnosis and intraoperative diagnosis was evaluated.
The intraoperative angiography data of patients who underwent selective bronchial artery embolization for hemoptysis in our hospital from January 2022 to December 2022 were reviewed. They were divided into the observation group and the control group based on whether there was recurrent hemoptysis. The Logistic regression model and forest map were employed to analyze the factors influencing the recurrence rate.
A total of 104 patients were encompassed in this study (12 cases of tuberculosis, 35 cases of infection, 4 cases of lung cancer, 8 cases of bronchiectasis, 22 cases of arteriovenous fistula, 16 cases of aneurysm, and 7 cases of pulmonary hypertension). The coincidence rate of preoperative and intraoperative diagnoses was 73.1%. Pulmonary arteriovenous fistula and aneurysm were the predominant types of diseases that were misdiagnosed. The short-term recurrence rate was 16.3%, mainly attributed to the reopening of responsible vessels related to embolization, angiography leakage, and leaky embolization of specific types of vessels. The recurrence rate of only patients with arteriovenous fistula and aneurysm accounted for 47% of the total recurrence rate. The right bronchial artery, right internal thoracic artery, right thyroid neck trunk, and age were the independent factors influencing the recurrence of hemoptysis (p < 0.05).
The main reason for angiographic leakage and embolization leakage in cases of hemoptysis is the lack of understanding of the anatomic variations of the vessels responsible. Careful examination of the specific types and locations of the vessels is the principal approach to reducing secondary operations.
回顾性研究血液系统疾病患者数字减影血管造影（DSA）血管造影时的异常解剖改变，统计分析短期（≤6个月）咯血复发的影响因素，并评估入院诊断与术中诊断的一致性。
回顾我院2022年1月至2022年12月因咯血行选择性支气管动脉栓塞术患者的术中血管造影资料。根据是否有咯血复发将其分为观察组和对照组。采用Logistic回归模型和森林图分析影响复发率的因素。
本研究共纳入104例患者（肺结核12例、感染35例、肺癌4例、支气管扩张8例、动静脉瘘22例、动脉瘤16例、肺动脉高压7例）。术前与术中诊断的符合率为73.1%。肺动静脉瘘和动脉瘤是误诊的主要疾病类型。短期复发率为16.3%，主要归因于与栓塞相关的责任血管再通、血管造影渗漏以及特定类型血管的栓塞渗漏。仅动静脉瘘和动脉瘤患者的复发率占总复发率的47%。右支气管动脉、右胸廓内动脉、右甲状腺颈干和年龄是影响咯血复发的独立因素（p＜0.05）。
咯血病例中血管造影渗漏和栓塞渗漏的主要原因是对责任血管的解剖变异缺乏了解。仔细检查血管的具体类型和位置是减少二次手术的主要方法。
