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肺动静脉畸形的外科治疗:两例报告并文献复习

Surgical treatment of pulmonary arteriovenous malformation: report of two cases and review of the literature.

作者信息

Metin K, Karaçelik M, Yavaçcan O, Celik M, Cetin N, Dorak M C, Oto O, Aksu N

机构信息

Department of Cardiovascular Surgery, Ege Sağlik Hospital, Izmir, Turkey.

出版信息

J Int Med Res. 2005 Jul-Aug;33(4):467-71. doi: 10.1177/147323000503300413.

Abstract

Pulmonary arteriovenous malformations (PAVMs) are rare anomalies. The degree of right-to-left shunting, which can lead to cyanosis and paradoxical embolism causing neurological complications, determines the prognosis. We report two cases of PAVM and review the literature. A 45-year-old woman with clinical signs and symptoms of PAVM was examined using several different scanning techniques, which showed a large PAVM in the lower lobe of her right lung. A lobectomy was performed, which revealed a 5 cm diameter PAVM with one feeding artery and multiple veins. Intravenous angiography of a 7-year-old girl with symptoms of fatigue and acro-cyanosis confirmed the presence of a large PAVM in her right lower lobe. The PAVM had two major arteries arising from the aorta, which were ligated during a lobectomy. Both patients recovered well following surgery. Although PAVMs are rare, their neurological and haemodynamic consequences may be fatal. Interventional treatment techniques, including surgery, are usually curative.

摘要

肺动静脉畸形(PAVM)是一种罕见的异常情况。右向左分流的程度决定了预后,这种分流可导致发绀和反常栓塞,进而引起神经并发症。我们报告两例PAVM病例并复习相关文献。一名有PAVM临床症状和体征的45岁女性接受了多种不同的扫描技术检查,结果显示其右肺下叶有一个大型PAVM。患者接受了肺叶切除术,术中发现一个直径5厘米的PAVM,有一条供血动脉和多条静脉。一名出现疲劳和肢端发绀症状的7岁女孩经静脉血管造影证实其右下叶存在一个大型PAVM。该PAVM有两条发自主动脉的主要动脉,在肺叶切除术中被结扎。两名患者术后恢复良好。尽管PAVM很少见,但其神经和血液动力学后果可能是致命的。包括手术在内的介入治疗技术通常可以治愈该病。

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