Jebali A, Gamondes J P, Wiesendanger T, Maret G, Brune J
Service de Chirurgie thoracique, Hôpital cardiovasculaire et pneumologique Louis Pradel, Bron.
Rev Pneumol Clin. 1989;45(6):250-7.
Arteriovenous fistula of the lung is a relatively rare lesion with various clinical manifestations. It may be clinically silent and discovered by chance on X-ray films of the chest or during evaluation of Rendu-Osler-Weber disease with which it is associated in about one-half of the cases. It may also have loud manifestations when complicated. The fistula is diagnosed in successive steps, mainly by respiratory function tests and pulmonary angiography. Conservative treatment should be the rule, especially in case with multiple fistulae, but it must begin at an early stage to avoid the dramatic complications of this abnormality, such as acute neurological disorders, haemoptysis, haemothorax, etc. Wide and crippling lung resection must be avoided. Aneurysmorrhaphy or embolization is sufficient to cure most of these multiple angiomas. The results obtained are measured by calculating the blood flow rate in the shunt, as it should theoretically disappear after surgery.
肺动静脉瘘是一种相对罕见的病变，有多种临床表现。它在临床上可能无症状，在胸部X光片检查时偶然发现，或在评估约一半病例与之相关的遗传性出血性毛细血管扩张症时被发现。当出现并发症时也可能有明显表现。动静脉瘘通过一系列步骤进行诊断，主要是通过呼吸功能测试和肺血管造影。应遵循保守治疗原则，特别是对于有多个瘘管的病例，但必须尽早开始，以避免这种异常的严重并发症，如急性神经功能障碍、咯血、血胸等。必须避免广泛且致残的肺切除术。动脉瘤缝扎术或栓塞术足以治愈大多数此类多发性血管瘤。通过计算分流中的血流速度来衡量手术效果，因为理论上术后分流应消失。
