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[肺灌注闪烁显像检测到的单侧肺循环缺失及其临床意义]

[Absence of unilateral pulmonary circulation, detected by perfusion scintigraphy of the lung, and its clinical significance].

作者信息

Galuska L, Márton H

机构信息

Bács-Kiskun Megyei Kórház, Kecskemét, Izotópdiagnosztika Osztály.

出版信息

Orv Hetil. 1996 Feb 25;137(8):411-4.

PMID:8714033
Abstract

Single acute shortage of pulmonary circulation may cause a life threatening condition, its definitive lack--in consequence of developmental trouble--decreased loading and inclination to infections. It's recognition is most easy by non invasive isotope perfusion pulmonary scintigraphy. Frequency, diagnostic difficulties are a little bit known in Hungary, therefore retrospective investigations were performed by the authors. Examining 961 perfusion pulmonary scintigraphic material of a four year (1990-1994) period-among them that of 52 children-in 8 cases total perfusion-lack of one lung-side was found. Surveyng history of 5 children and 3 adults, besides conventional physical and X-ray suspicion-sings, attention is drawn to signs of non-invasive perfusion and aerosol inhalation pulmonary scintigraphy which are more suitable to demonstrate deviations. In the background of severe circulatory trouble there have been found in one infant grave bronchial stenosis, in 4 children--with different age--arteria pulmonalis agenesia at right, and in 1 young adult (with Fallot-tetralogy), ateria pulmonalis agenesia at left. One of the other adults had bronchial carcinoma, and the other massive pulmonary embolisation. In their diagnostic schedule besides isotope investigations, importance of cardiologic echo-examinations, and the bronchoscopy has been stressed respectively. Catheterisation of the heart is important only in selected cases.

摘要

肺循环的单次急性短缺可能导致危及生命的状况,其绝对缺乏(由于发育问题)会导致负荷降低和易感染倾向。通过无创同位素灌注肺闪烁扫描最容易识别这种情况。在匈牙利,其发生率和诊断困难程度鲜为人知,因此作者进行了回顾性研究。检查了四年(1990 - 1994年)期间的961份灌注肺闪烁扫描资料,其中52例为儿童,发现8例一侧肺完全缺乏灌注。在对5名儿童和3名成人的病史进行调查时,除了传统的体格检查和X线可疑征象外,还应注意无创灌注和气溶胶吸入肺闪烁扫描的征象,这些征象更适合显示异常情况。在严重循环障碍的背景下,发现1例婴儿有严重的支气管狭窄,4例不同年龄段的儿童右侧肺动脉发育不全,1例年轻成人(法洛四联症)左侧肺动脉发育不全。另一名成人患有支气管癌,另一名患有大面积肺栓塞。在他们的诊断方案中,除了同位素检查外,还分别强调了心脏超声检查和支气管镜检查的重要性。心脏导管检查仅在特定情况下重要。

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