双主动脉弓临床诊治进展

Advances in clinical diagnosis and treatment of double aortic arch

双主动脉弓是胚胎发育过程中第四对主动脉弓发育异常所致的一类先天性主动脉弓畸形。该病临床表现并不典型,常压迫气管食管,严重时引起呼吸困难和吞咽困难,甚至危及生命。目前主要通过超声心动图、计算机断层血管造影、磁共振血管成像、心导管造影等影像学成像技术诊断,治疗以手术为主。早期诊断、早期干预,避免气管软化,对改善预后有重要的临床意义。该文将对双主动脉弓的胚胎发育机制、分型、临床诊断、治疗及预后的研究进展作一简要综述,以提高该病的诊治水平。

Double aortic arch is a congenital aortic arch malformation,which is caused by abnormal development of the fourth aortic arches during embryonic development.The patient with double aortic arch has no specific symptoms.It often encircles the trachea and esophagus.In severe cases,it causes dyspnea and dysphagia,and even endangers life.Currently,double aortic arch is diagnosed mainly by imaging techniques,such as echocardiography,computed tomography angiography,magnetic resonance angiography,cardiac catheterization.The main treatment is surgery.Therefore early diagnosis and treatment are very important to avoid tracheomalacia and improve the prognosis.This article will briefly review the research progress of embryonic development mechanism,classification,clinical diagnosis,treatment and prognosis of double aortic arch,aiming to improve the physician′s skills of diagnosis and treatment.