肺动静脉瘘的诊断与治疗(附7例报告)

Diagnosis and Therapy of Pulmonary arteriovenous Fistula: A report of 7 cases

目的:分析总结7例肺动静脉瘘的胸部平片、CT及血管造影表现,找出诊断要点,比较和分析外科手术治疗和介入栓塞方法的治疗结果。材料和方法:男性3例,女性4例,年龄从4岁至63岁,平均年龄27.5岁。7例均在术前行肺动脉造影及术前术后血气分析;5例经胸部CT检查。结果:肺动脉造影结果显示,局限型单发2例,多发4例;弥漫型并肺动脉高压1例。多发型中2例经栓塞方法部分治愈。动脉血氧分压分别由术前4.5kpa,3.5kpa(59.2mmHg,47.2mmHg)上升至6.0kpa,4.0kpa(79.7mmHg,53.8mmHg);血红蛋白由15.8g％、17.0g％降至13.1g％、13.0g％。2例多发型和2例单发型经外科手术切除病变肺叶,动脉血氧分压、血红蛋白含量恢复正常。结论:认识本病,结合胸部平片及血气分析诊断不难,确诊需肺动脉造影。传统的外科手术方法治疗有损正常肺组织功能之虞。介入栓塞法治疗创伤小、疗效肯定,并可重复实施。精细的操作。

Purpose: Study and describe finds of the chest plain, CT and angiogram about 7 cases PAVF.To compare and analyze therapy methods both surgical and embolization,and that results. Material and method:Male 3 cases, female 4 cases, Age from 4 years to 63 years.Total cases carried out pulmonary angiogram and blood gas analysis at pre - postoperation. 5 cases were underwent CT of chest. Result: Carried out pulmonary angiogram shows multiples sac-cular 4 cases; single saccular 2 cases; diffuse capillary 1 cases Multiple 2 cases were treated with embolitherapy using coils,postoperation PaO2from 4.5Kpa,3.5Kpa increased to 6.0Kpa,4.0Kpa;Hgb from 15.8g% , 17.0g% decreased to 13. 1g% ,13.0g% . Multiple 2 cases and single 2 cases were treated with surgery, PaO2and Hgb were recovered. Conclusion: PAVF diagnosis have not difficult depend on recongnize clinical significance and combined with chest plain and blood gas analysis. Final diagnosis needs pulmonary angiogram. Conventional surgery has worry of loos funcation for normal lung.Interventional embolization has harmfulless, efficiency and can be recarried out.Key of effeciency were perform in carefully and fitting embolic agents be selected.