螺旋弹簧圈堵塞术治疗先天性肺动静脉瘘

目的总结螺旋弹簧圈(Coil)堵塞术治疗先天性肺动静脉瘘的经验及疗效。方法回顾性分析用Coil弹簧栓堵塞治疗的肺动静脉瘘7例患者，其中单发囊状型4例，多发囊状型2例，多发弥漫型1例。结果7例患者均栓塞成功。6例囊性肺动静脉瘘平均股动脉血氧饱和度由术前87％上升为术后96％。1例弥漫型肺动静脉瘘在栓塞术中出现一过性胸前区隐痛，经分期堵塞血氧饱和度由术前79％上升为87％。随访6个月至5年，仅弥漫型肺动静脉瘘1例血氧饱和度较术后轻度下降，并超声心动图提示出现轻中度右房室瓣关闭不全，余病例均无复发。结论Coil堵塞术治疗先天性囊状型肺动静脉瘘是安全有效的治疗方法，但对弥漫型者仅为一姑息治疗，疗效有待经验总结。

Coil embolization for the therapy of pulmonary arteriovenous malformations in 7 patients

Objective To analyze the efficacy and experience of coil embolization in patients with pulmonary arteriovenous malformations(PAMV). Methods Seven patients (2 males and 5 females, age range from 11 to 52 years; mean age 31 years) were admitted including 4 single saccular, 2 multiple saccular, 1 diffuse capillary pulmonary arteriovenous malformations. Results Coil embolization of pulmonary arteries was successful in all 7 patients. The mean arterial oxygen saturation rate increased from 87% to 96% in patients with saccular PAMV. Transient chest pain occurred in a case of diffuse capillary PAMV during the procedure, after undergoing multiple coil embolization, the arterial oxygen saturation rate increased from 79% to 87%. All patients were followed up for 6 months to 5 years, arterial oxygen saturation declined slightly,and mild to moderate tricuspid regurgitation was found by echocardiography only in the patient with diffuse capillary PAMV.Conclusion Coil embolization is an effective and safe method of treatment for saccular PAMV. But it is only a palliative therapy for diffuse capillary PAMV.