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Chest:钟前进教授等报道先天性降主动脉肺静脉瘘一例

2013-07-03 萧弈 dxy

患者,女性,25岁,因反复喀血1年+入院。患者最初的6个月咳血丝痰,随后症状开始加重,咳鲜红色血或血凝块。活动和月经与症状的发作无关。自述无发热、胸痛、盗汗、气促和抗凝剂使用史。体格检查:患者的一般情况良好。 在胸骨旁左侧第四肋间可问及3/6及收缩期杂音,肺动脉瓣关闭音正常。超声心动图显示心脏轮廓正常,没有任何缺陷和异常交通。胸片显示左肺下叶光滑高密度阴影。胸部增强CT显示异常血



患者,女性,25岁,因反复喀血1年+入院。患者最初的6个月咳血丝痰,随后症状开始加重,咳鲜红色血或血凝块。活动和月经与症状的发作无关。自述无发热、胸痛、盗汗、气促和抗凝剂使用史。体格检查:患者的一般情况良好。
在胸骨旁左侧第四肋间可问及3/6及收缩期杂音,肺动脉瓣关闭音正常。超声心动图显示心脏轮廓正常,没有任何缺陷和异常交通。胸片显示左肺下叶光滑高密度阴影。胸部增强CT显示异常血管分支,降主动脉的异常血管在与下肺静脉进入左心房前相交通,最狭窄处内径为9mm。下肺静脉膨胀。血管造影显示造影剂在回流到下肺静脉汇入左心房之前,通过降主动脉-肺静脉瘘(DAPVF)流入下肺静脉的分支。
术中发现左下肺基底段异常血管明显增生;异常血管从降主动脉发出分支进入左下肺;通过左侧进胸,采用动脉导管未闭时的手术方法,将异常血管予以结扎。患者术后恢复良好,随访六月未再出现咯血症状。
总结:DAPVF是血管畸形的一种少见形式,应与肺隔离症相鉴别。手术结扎可以得到良好的治疗效果。

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    2014-12-26 生物谷客户端朋友

    我们自己选择题

    0

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    2014-05-05 fusion
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    2014-02-07 Smile2680
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    2013-07-10 libolb2006

    有没有肺高压?

    0

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    2013-07-05 huirong
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