关键词: 结核,肺, 咯血

Abstract: Objective To analyze the nonbronchial arterial angiography for middling and massive hemoptysis of pulmonary tuberculosis and evaluate their interventional treatment effect.Methods The 214 patients with pulmonary tuberculosis received intercostals and subclavian angiography,among them,intercostals and bronchial arterial bleeding were found in 153 patients,mammaria interna and bronchial arterial bleeding were found in 3 patients,mammaria interna and intercostals and bronchial arterial bleeding were found in 4 patients,mammaria interna and intercostals and superior thoracic and thoracica lateralis and bronchial arterial bleeding were found in 2 patients,mammaria interna and intercostals and thyrocervical trunk and bronchial arterial bleeding were found in 1 patient,intercostals and Inferior phrenic and bronchial arterial bleeding were found in 2 patients.The obvious bleeding arteries were embolized and analysed for clinical efficacy and complications.Results The digital subtraction angiography showed the bleeding sign was found in 465 intercostals arteries,among them,10.9% had contrast medium outflow.96.9% had reticulate new vascular,43.2% had intercostals artery to pulmonary artery fistula and intercostals artery to pulmonary vein fistula,32.9% had collateral circulation between arteries.The 10 mammaria interna arteries and two superior thoracic and two thoracica lateralis and one thyrocervical trunk and two inferior phrenic had reticulate new vascular and collateral circulation between intercostals artery and bronchial artery.The effective power was 84.2% in embolization,and 96.4% in repetitious embolization,and the complications occurred with chest distress,chest pain,and fever.Conclusions The intercostals,mammaria interna,superior thoracic,thoracica lateralis,thyrocervical trunk and inferior phrenic angiography and embolization have important clinical value in middling and massive hemoptysis treatment of pulmonary tuberculosis.It can improve curative effect and prevent relapse.

Key words: Pulmonary tuberculosis, Hemoptysis