肺动静脉瘘13例的诊断和外科治疗分析

Surgical treatment for pulmonary arteriovenous fistula

目的总结肺动静脉瘘的诊断和外科治疗的经验。方法对13例肺动静脉瘘病例资料进行回顾性分析。结果 13例中11例经胸部螺旋CT扫描及血管三维重建确诊,2例经肺动脉造影确诊;手术治疗12例,肺叶切除10例,肺楔形切除2例,手术后症状消失或改善,临床治疗效果满意;1例弥漫型患者放弃治疗。结论螺旋CT扫描及血管三维重建是肺动静脉瘘目前最常用的诊断手段,对于局限性病变外科手术有良好的疗效,手术方式应根据病情灵活掌握。

Objective To Bummarize the experience in dlagnosis and surgical treatment of pulmonary arterlovenous fistula. Methods Clinical data of 13 patients with pulmonary arteriovenous fistula were retrospectively ana- lyzed. Results Eleven patients were diagnosed by chest spiral CT scan and vascular three-dimensional reeonstrue- tion, two patients were diagnosed by pulmonary angiography. Twelve patients received surgical operation successfully, lobectomy in 10 patients, pulmonary wedge resections in 2 patients. Symptoms disappeared or improved after opera- tion, and clinical results were satisfactory. One patient with diffuse lesion gave up treatment. Conclusion Spiral CT scanning and vascular three-dimensional reeonstruetion are the most common diagnostic tools for pulmonary arteriove- nous fistula. Surgery for limited pulmonary arteriovenons fistula has a good effect, and surgical procedure should be flexibly used on the basis of disease conditions.