多学科诊疗模式下以不同方法治疗肺动静脉畸形

目的 观察多学科诊疗（MDT）模式下以不同方法治疗肺动静脉畸形（PAVM）的有效性及安全性。方法 对31例PAVM患者行MDT，对比介入治疗、手术治疗及保守治疗用于PAVM的有效性及安全性。结果 31例中，22例接受介入治疗（介入组），4例接受手术治疗（手术组），5例接受保守治疗（保守组）。介入组22例均成功栓塞PAVM，技术成功率100%（22/22）；3例出现胸膜炎（3/22，13.64%），随访期间4例PAVM复发（4/22，18.18%），经二次介入治疗后均未复发。手术组4例均成功行胸腔镜下病变肺叶切除术，技术成功率100%（4/4），均未出现术后并发症；随访期间2例PAVM复发（2/4，50.00%），1例接受介入治疗、1例接受保守治疗。保守组5例中，3例PAVM进展（3/5，60.00%）；其中2例经介入治疗后未复发、1例接受保守治疗后死于脑卒中。结论 MDT模式下以不同方法个体化治疗PAVM具有可行性；相比手术及保守治疗，介入治疗PAVM更为有效且相对安全。

Different methods for treating pulmonary arteriovenous malformation under multi-disciplinary treatment model

Objective To observe the effectiveness and safety of different methods under multi-disciplinary treatment (MDT) model for treating pulmonary arteriovenous malformation (PAVM). Methods MDT were retrospectively performed in 31 patients with PAVM. The effectiveness and safety of interventional therapy, surgical treatment and conservative therapy for PAVM were compared. Results Among 31 cases of PAVM, 22 cases underwent interventional therapies (interventional group), 4 cases received surgical treatments (surgical group) and 5 cases underwent conservative therapies (conservative group). In interventional group, PAVM was successfully embolized in all 22 cases, with the technical success rate was 100% (22/22). Pleurisy was occurred in 3 cases (3/22, 13.64%), while recurrence of PAVM was noticed in 4 cases (4/22, 18.18%) during follow-up. No recurrence occurred in interventional group after the second interventional therapies. In surgical group, 4 cases were successfully treated with thoracoscopic lobectomy, with the technical success rate of 100% (4/4). No postoperative complication occurred, while recurrence of PAVM was noticed in 2 cases (2/4, 50.00%) during follow-up, including 1 case underwent interventional therapy and 1 case underwent conservative therapy. In conservative group, progressive PAVM was observed in 3 cases (3/5, 60.00%), including 2 cases who were cured with interventional therapy and 1 case died of stroke after conservative therapy. Conclusion Individualized treatments of PAVM were feasible under MDT model. Compared with surgical treatments and conservative therapies, interventional therapies of PAVM were more effective and relatively safe.