39例成人冠状动脉瘘临床分析

Clinical Analysis of 39 Adult Patients with Coronary Fistulas

目的 :探讨成年人冠状动脉瘘的临床特点 ,提高诊治水平。方法 :回顾分析 39例成年人冠状动脉瘘患者的临床资料。结果 :冠状动脉瘘来自左冠状动脉 2 0例 (5 1.3% ) ;来自右冠状动脉 12例 (30 .8% ) ;来自双侧冠状动脉 7例 (17.9% )。入院时误诊、漏诊共 2 3例 ,误诊漏诊率达 5 9.0 % ;12例中、老年患者误诊为冠心病。 2 5例行手术治疗 ,手术均成功 ,预后均良好。结论 :成人冠状动脉瘘误诊漏诊率高 ,尤其中、老年患者易误诊为冠心病。超声心动图对本病诊断有较高的价值。对病史或检查有怀疑时及时行心血管造影检查可确诊 ,术后预后良好。

Objective: To evaluate the clinical characteristics, diagnosis, reason of misdiagnosis, treatment and prognosis of coronary fistulas in adults. Methods: Thirty-nine adult cases of coronary fistulas from November 1994 to September 2003 were retrospectively analyzed. Results: The nate of coronary fistulas from left coronary artery was 51.3%, from right coronary artery was 30.8%, and 17.9% from both. Amony them 23 patients were misdiagnosed or missed diagnosed on admision inchuding 12 middle-aged or patients aging as coronaly heact disease. 25 patients were operated successfully with good prognosis. Conclusion:The ratio of misdiagnosis in adult cases of coronary fistulas is high, especially in middle-aged or aged patients often misdiagnosed as coronaly heast diceasl. Echocardiogram have high value in diagnosis of coronary fistulas. When there was suspicion in history, souffle or examination, Angiocardiography should be arother importart adjunst for the diagroses aperation for these pationts would law good peogroere.