[儿童肺动静脉瘘的经皮栓塞治疗]
[Percutaneous embolization of a pulmonary arteriovenous fistula in a child].
作者信息
Callebaut B, Sluysmans T, Stijns M, Lintermans J, Vliers A
机构信息
Service de cardiologie pédiatrique, Cliniques universitaires Saint-Luc, université catholique de Louvain, Bruxelles, Belgique.
出版信息
Arch Pediatr. 1994 Jan;1(1):46-8.
BACKGROUND
Pulmonary arteriovenous fistula is a rare vascular abnormality in children that is usually treated by lobectomy. This report describes a case that was improved by coil embolization.
CASE REPORT
A thoracic X-ray was routinely taken before amygdalectomy in a 6 year-old girl. It showed a consolidation area in the left superior lobe that persisted despite treatment with erythromycin for 3 weeks. Bronchoscopy was normal, but study of blood gases showed a refractory hypoxemia with moderate cyanosis and hemoglobin at 16.2 g/dl. Right-heart catheterization and angiography showed a pulmonary arteriovenous fistula that was treated by coil embolization. A control investigation 3 months later showed normal arterial oxygen saturation, hemoglobin at 14.5 g/dl and reduced pulmonary condensation.
CONCLUSION
Pulmonary arteriovenous fistula may show few symptoms. Coil embolization appears to be a useful initial non-aggressive treatment.
背景
肺动静脉瘘是儿童罕见的血管异常，通常采用肺叶切除术治疗。本报告描述了一例通过弹簧圈栓塞得到改善的病例。
病例报告
一名6岁女孩在扁桃体切除术前常规进行胸部X线检查。结果显示左上叶有一个实变区，尽管使用红霉素治疗3周后仍持续存在。支气管镜检查正常，但血气分析显示难治性低氧血症，伴有中度发绀，血红蛋白为16.2 g/dl。右心导管检查和血管造影显示为肺动静脉瘘，通过弹簧圈栓塞进行治疗。3个月后的对照检查显示动脉血氧饱和度正常，血红蛋白为14.5 g/dl，肺部实变减轻。
结论
肺动静脉瘘可能症状较少。弹簧圈栓塞似乎是一种有效的初始非侵袭性治疗方法。
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