摘要
目的总结分析肺动静脉瘘(pulmonary arteriovenous malformation,PAVM)的临床特点,以提高对PAVF的认识,做到早诊断、早治疗。方法对1例PAVF患者的病史、临床表现、辅助检查及治疗经过结合有关文献进行回顾性分析。结果本例患者女性1,8岁,因体检时发现右肺占位一月入院。查:口唇紫绀,SpO2为88%。胸部64排螺旋CT示:右肺中叶动静脉瘘,见2根肺动脉及1根肺静脉进入瘘囊内。在全麻下行"右肺中叶切除术"。术中顺利,术后恢复平稳,SpO2升至97%。病理报告示:符合肺动静脉瘘改变。随访一个月,无紫绀,肺部阴影消失,已恢复正常学习。结论多层螺旋CT+三维重建技术完全可以满足对PAVF的诊断需要,应成为诊断PAVF的最佳影像方法。介入栓塞治疗对于分布范围较广泛的散在多发病灶或单纯型的小病灶较为合适。考虑到远期疗效及安全性,手术切除仍是主要治疗方法。
Objective To report a case of pulmonary arteriovenous fistula（PAVF）,and to review its clinical characteristics,early diagnosis methods and treatments.Method The case history,clinical findings,auxiliary examination and treatment of an 18 years old female with PAVF was retrospective analyzed with relevant literature.Results The girl was found lips cyanosis and right lung space occupying with SpO2 of 88% in health examination.64-detector row spiral CT of the chest showed arteriovenous fistula in the middle lobe of right lung with 2 pulmonary arteries and 1 pulmonary vein perfusing into the fistula capsule.The patient underwent right middle lobe resection under general anesthesia.She recovered well with SpO2 rising to 97%.So she lived a good life without cyanosis.The pathology report showed PAVF.Conclusions With the advances in diagnostic techniques and the awareness of this disease,the number of PAVF cases will be more and more.Three dimensional reconstruction of multi-slice spiral CT technology can meet the needs for diagnosis of PAVF,which should be the best imaging method for diagnosis of PAVF.Interventional embolization therapy might be appropriate for wide distributions of sporadic foci or simple small lesions.Surgical excision is still the main treatment method for account of the long-term efficacy and safety.
出处
《中国现代手术学杂志》
2011年第6期446-448,共3页
Chinese Journal of Modern Operative Surgery
关键词
动静脉瘘
肺
外科手术
诊断
预后
arteriovenous fistula
lung
surgical procedures
diagnosis
prognosis
