先天性肺动-静脉畸形的介入治疗

目的:总结先天性肺动-静脉畸形(pulmonary arteriovenous malformation,PAVM)的介入治疗方法及效果。方法:回顾分析16例先天性PAVM患者的介入治疗,术前均行右心导管检查及肺动脉造影,观察PAVM的部位及类型,确定供血动脉并测量供血动脉的直径,根据部位及直径的不同分别使用弹簧圈、血管塞或PDA封堵器进行栓塞。介入术前、后均测定患者动脉血氧饱和度。术后随访6²4个月。结果:16例患者(男性9例,女性7例),平均年龄为30岁,肺动脉造影显示:8例为单发囊状,6例为多发囊状,2例为多发弥散型,16例供血动脉总计为25条,供血动脉直径为324个月。结果:16例患者(男性9例,女性7例),平均年龄为30岁,肺动脉造影显示:8例为单发囊状,6例为多发囊状,2例为多发弥散型,16例供血动脉总计为25条,供血动脉直径为3⁸ mm。本组病例介入治疗均获得成功,共置入弹簧圈34枚、血管塞13枚,PDA封堵器8枚,术后供血动脉栓塞完全,瘤囊未显影,无严重并发症发生。术后动脉血氧饱和度明显增高,临床症状明显改善。结论:介入治疗先天性PAVM安全可行,近期疗效满意。

The interventional treatment of pulmononary arteriovenous malformation

Objective： To summarize the experience and examine the efficacy of interventional treat- ment for congenital pulmonary arteriovenous malformation （PAVM）. Methods： A retrospective analysis of 16 patients with PAVM who underwent interventional treatment was performed. All patients received right heart catheterization and pulmonary artery angiography before operation to observe the location and type of PAVM and to identify and measure the vessel of blood supply. Materials such as coils,vascular plug or PDA occluder were selected based on the site and diameter of blood supply vessel. Pre- and post-operative measurement of arterial oxygen saturation is necessary for all patients. Postoperative follow-up ranged from six months to two years. Re- stilts： Mean age of sixteen patients （9 men and 7 women） with PAVM was 30 years old. Pulmonary arterial an- giography showed single saccular, multiple saccular and diffuse capillary PAVM in 8, 6 and 2 patients. The number of all blood supply vessels was 25 and measured diameter of these feeding vessels was 3 - 8 mm. Tech- nical success was reached for all patients, with 34 coils, 13 vascular plugs and 8 PDA occluders used. Postope- artive angiography showed total occlusion of all blood supply vessels and undeveloped aneurysmal sac. No ad- verse complications occurred for all patients. Arterial oxygen saturation increased and Clinical symptoms im- proved greatly. Conclusion： It was both feasible and safe for the interventional treatment of PAVM, which showed good short-term result.