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治疗复发性咯血的主支气管瘘的有效策略。

Effective strategy in the treatment of aortobronchial fistula with recurrent hemoptysis.

作者信息

Son Shin-Ah, Lee Deok Heon, Kim Gun-Jik

机构信息

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.

出版信息

Yeungnam Univ J Med. 2020 Apr;37(2):141-146. doi: 10.12701/yujm.2019.00444. Epub 2020 Feb 25.

DOI:10.12701/yujm.2019.00444
PMID:32131081
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7200220/
Abstract

Aortobronchial fistula (ABF) involves the formation of an abnormal connection between the thoracic aorta and the central airways or the pulmonary parenchyma and is associated with an increased risk of mortality. An ABF typically manifests clinically with symptoms of hemoptysis, and currently, there is a lack of defined guidelines for its treatment. Here, we report the cases of two patients who suffered from recurrent hemoptysis due to ABF with pseudoaneurysm. We propose that removal of the aorta with concomitant lung resection and coverage of the aorta using the pericardial membrane is a definite treatment to lower recurrence of ABF and persistent infection.

摘要

主动脉支气管瘘（ABF）是指胸主动脉与中央气道或肺实质之间形成异常连接，与死亡风险增加相关。ABF临床上通常表现为咯血症状，目前其治疗缺乏明确的指南。在此，我们报告两例因ABF合并假性动脉瘤而反复咯血的患者病例。我们提出，切除主动脉并同时进行肺切除术，以及用心包膜覆盖主动脉，是降低ABF复发和持续感染的确定性治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/6a373177e620/yujm-2019-00444f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/2c2611782e92/yujm-2019-00444f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/5d94ec930407/yujm-2019-00444f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/8d1f1eece7d3/yujm-2019-00444f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/6a373177e620/yujm-2019-00444f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/2c2611782e92/yujm-2019-00444f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/5d94ec930407/yujm-2019-00444f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/8d1f1eece7d3/yujm-2019-00444f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1348/7200220/6a373177e620/yujm-2019-00444f4.jpg

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本文引用的文献

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Aortopulmonary Fistula Presenting without an Endoleak after Thoracic Endovascular Aortic Repair.胸段血管腔内主动脉修复术后无内漏的主肺动脉瘘
Korean J Thorac Cardiovasc Surg. 2017 Aug;50(4):287-290. doi: 10.5090/kjtcs.2017.50.4.287. Epub 2017 Aug 5.
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Aorto-bronchial and aorto-pulmonary fistulation after thoracic endovascular aortic repair: an analysis from the European Registry of Endovascular Aortic Repair Complications.胸主动脉腔内修复术后的主动脉-支气管和主动脉-肺动脉瘘：来自欧洲血管腔内主动脉修复并发症注册研究的分析
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Emergency open surgery for aorto-oesophageal and aorto-bronchial fistulae after thoracic endovascular aortic repair: a single-centre experience†.
胸主动脉腔内修复术后主动脉-食管和主动脉-支气管瘘的急诊开放手术：单中心经验†
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Combined endovascular and surgical approach for aortobronchial fistula.主动脉支气管瘘的血管内与外科联合治疗方法
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Open aortic repair after prior thoracic endovascular aortic repair.先前胸主动脉腔内修复术后的开放式主动脉修复。
Ann Thorac Surg. 2014 Mar;97(3):750-6. doi: 10.1016/j.athoracsur.2013.10.033. Epub 2014 Jan 8.
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Thoracic endovascular aortic repair for aortobronchial fistula.胸主动脉腔内修复术治疗主动脉支气管瘘。
Ann Thorac Surg. 2013 Sep;96(3):1117-21. doi: 10.1016/j.athoracsur.2013.04.090. Epub 2013 Aug 2.
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New insights regarding the incidence, presentation and treatment options of aorto-oesophageal fistulation after thoracic endovascular aortic repair: the European Registry of Endovascular Aortic Repair Complications.关于胸主动脉腔内修复术后主动脉-食管瘘的发生率、表现及治疗选择的新见解：欧洲血管腔内主动脉修复并发症登记处
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