支气管动脉CT血管造影引导下的超选择性支气管动脉栓塞术治疗儿童咯血和肺出血：一项单中心回顾性研究
Superselective bronchial artery embolization guided by bronchial artery CT angiography for pediatric hemoptysis and pulmonary hemorrhage: a retrospective single-center study.
摘要(中文译文)
支气管动脉栓塞术（BAE）是成人危及生命的咯血已确立的一线治疗方法；然而，其在儿科患者中的安全性和有效性证据仍然有限，尤其是在特发性肺含铁血黄素沉着症相关肺出血患儿中。本回顾性研究评估了2018年1月至2025年9月期间接受治疗的33例咯血或肺出血儿科患者中，支气管动脉（BA）计算机断层血管造影引导下超选择性BAE的临床疗效、血管造影特征及中期结局。所有患者均接受了术前BA计算机断层血管造影，随后进行数字减影血管造影引导下栓塞。分析了临床特征、BA特征、出血严重程度、手术结局及随访数据。共栓塞81条支气管动脉，技术成功率为100%，未发生重大手术相关并发症。出血严重程度与病因（² = 8.986， = 0.029）、BA总数（² = 9.287， = 0.001）及BA最大直径（² = 6.222， = 0.005）显著相关。特发性肺含铁血黄素沉着症患者更易表现为严重或危及生命的出血，而非特发性肺含铁血黄素沉着症患者则主要表现为轻至中度咯血。BA数量随出血严重程度逐渐增加，危及生命出血的患者中观察到较大的BA直径。特发性肺含铁血黄素沉着症的数字减影血管造影表现为弥漫性肺实质造影剂外渗和紊乱的远端血管增生。随访期间，仅1例特发性肺含铁血黄素沉着症患者出现咯血复发。这些发现表明，BA计算机断层血管造影引导下超选择性BAE是儿科咯血和肺出血一种可行且可能有益的微创治疗方法，在特发性肺含铁血黄素沉着症相关危及生命肺出血患儿中可能尤其有价值。
Abstract
Bronchial artery embolization (BAE) is an established first-line treatment for life-threatening hemoptysis in adults; however, evidence regarding its safety and efficacy in pediatric patients remains limited, particularly in children with idiopathic pulmonary hemosiderosis-associated pulmonary hemorrhage. This retrospective study evaluated the clinical efficacy, angiographic characteristics, and mid-term outcomes of bronchial artery (BA) computed tomography angiography-guided superselective BAE in 33 pediatric patients with hemoptysis or pulmonary hemorrhage treated between January 2018 and September 2025. All patients underwent preprocedural BA computed tomography angiography followed by digital subtraction angiography-guided embolization. Clinical characteristics, BA features, bleeding severity, procedural outcomes, and follow-up data were analyzed. A total of 81 bronchial arteries were embolized, with a technical success rate of 100%, and no major procedure-related complications occurred. Bleeding severity was significantly associated with etiology (² = 8.986, = 0.029), total BA number (² = 9.287, = 0.001), and maximum BA diameter (² = 6.222, = 0.005). Patients with idiopathic pulmonary hemosiderosis were more likely to present with severe or life-threatening bleeding, whereas non-idiopathic pulmonary hemosiderosis patients predominantly exhibited mild to moderate hemoptysis. BA number increased progressively with bleeding severity, and larger BA diameters were observed in patients with life-threatening hemorrhage. Digital subtraction angiography in idiopathic pulmonary hemosiderosis demonstrated diffuse parenchymal contrast extravasation and disorganized distal vascular proliferation. During follow-up, recurrent hemoptysis occurred in only one patient with idiopathic pulmonary hemosiderosis. These findings suggest that BA computed tomography angiography-guided superselective BAE is a feasible and potentially beneficial minimally invasive treatment for pediatric hemoptysis and pulmonary hemorrhage and may be particularly valuable in children with idiopathic pulmonary hemosiderosis-associated life-threatening pulmonary hemorrhage.
如何引用
AMA
Dechao Wang, Lei Zhang, Fengqin Liu, Jijun Li, Jie Chen. Superselective bronchial artery embolization guided by bronchial artery CT angiography for pediatric hemoptysis and pulmonary hemorrhage: a retrospective single-center study.. Frontiers in pediatrics. 2026; doi:10.3389/fped.2026.1878174.
APA
Dechao Wang, Lei Zhang, Fengqin Liu, Jijun Li, Jie Chen (2026). Superselective bronchial artery embolization guided by bronchial artery CT angiography for pediatric hemoptysis and pulmonary hemorrhage: a retrospective single-center study.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2026.1878174
GB/T 7714
Dechao Wang, Lei Zhang, Fengqin Liu, Jijun Li, Jie Chen. Superselective bronchial artery embolization guided by bronchial artery CT angiography for pediatric hemoptysis and pulmonary hemorrhage: a retrospective single-center study.[J]. Frontiers in pediatrics, 2026 doi:10.3389/fped.2026.1878174.
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