先天性支气管动脉-肺动脉瘘儿童咯血的介入治疗临床分析.

Objective: To summarize the clinical characteristics, diagnosis and treatment experience of congenital bronchial artery-pulmonary artery fistula in children, and to explore the safety and effectiveness of interventional treatment for hemoptysis caused by bronchial artery-pulmonary artery fistula. Methods: 36 children with hemoptysis caused by bronchial artery-pulmonary artery fistula admitted to our hospital from July 2009 to June 2017 were retrospectively analyzed, bronchial arteriography was performed under digital subtraction angiography(DSA), bronchial arterial embolism was performed with 300-700 滋m polyvinyl alcohol (PVA) microembolic particles or microspheres granules. The efficacy was evaluated. The patients were reexamined at 1 month, 3 month, 6 month and 1 year after operation: Results: Multislice spiral CT angiography (MSCTA) showed that diagnostic rate of direct signs of congenital bronchial artery-pulmonary artery fistula was 55.5 % (20/36), 16 cases were false negative (44.4 %) and no false positive cases were found; The immediate success rate was 100 % and the recurrence rate was 13.9 %(5/36) in 36 patients after embolization. The recurrence occurred 2-6 months after operation, which showed hemoptysis again, but the amount of hemoptysis was less than that before the initial occlusion, all patients underwent secondary embolization. Conclusion: Interventional treatment for hemoptysis caused by bronchial artery-pulmonary artery fistula is a minimally invasive, simple, effective and less complications treatment method. In order to further reduce the risk of recurrence, MSCTA should be performed carefully before operation, DSA angiography should be performed comprehensively, appropriate permanent embolic agents should be selected according to the patient's vascular lesions, and appropriate embolization techniques should be used. [ABSTRACT FROM AUTHOR]