肺动静脉瘘的栓塞治疗和并发症的预防与对策

Therapeutic embolization of pulmonary arteriovenous fistula and strategy of preventing the complications

目的应用介入栓塞的方法治疗肺动静脉瘘,探讨栓塞治疗中并发症产生的应对对策。方法回顾性分析栓塞4例肺动静脉瘘诊治的临床资料。结果4例患者栓塞成功,其相应的临床症状及体征基本消失。1例多支供血的右肺动静脉瘘经2次栓塞封堵了供血动脉;1例右肺动静脉瘘栓塞中微钢圈脱落至左房,经股静脉入路行房间隔穿刺后取出。结论介入栓塞是治疗肺动静脉瘘的有效方法,操作得当可避免并发症的发生。

Objective To investigate the strategy of preventing the complications that occurred during therapeutic embolization of pulmonary arteriovenous fistula（AVF）.Methods The diagnosis and therapeutic procedures of 4 cases of pulmonary AVF were respectively analyzed.Results Embolization was successfully performed in all 4 cases,and relative symptoms disappeared after treatment.Repeat embolization was performed in 1 case with multiple feeding vessels in the right pulmonary artery.The feeding arteries were successfully blocked after the second embolization.A micro-coil fell off into the left atria sinistrum during embolization in 1 case with AVF in the right lung,and then was successfully taken out with atrial septum puncture via femoral vein approach.Conclusion Embolization is an effective treatment for pulmonary AVF.Correct operation can avoid complications.