部分肺静脉异位引流畸形的漏诊原因分析 |
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引用本文: | 朱延力,陈国桢,李运泉,覃有振,李格丽. 部分肺静脉异位引流畸形的漏诊原因分析[J]. 岭南心血管病杂志, 2000, 6(5): 361-362 |
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作者姓名: | 朱延力 陈国桢 李运泉 覃有振 李格丽 |
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作者单位: | 广州市中山医科大学附属第一医院心儿科510080 |
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摘 要: | 目的:分析部分肺静脉引流(PAPVD)的漏诊原因,以提高术前的准确率和防止手术失误,方法:回顾性分析自1991年1月至1999年10月经手述评上实的PAPVD15例临床资料与手术结果,找出临床漏诊的原因。结果:本组15例PAPVD手术前仅1例诊断明确,漏诊13例,术中失误1例。15例术中均见伴有房间隔缺损(ASD),并肺动脉瓣狭窄3例,肺动脉高压3例,畸莆引流的部分以右房为最多,其次是上腔静脉,畸形引流的肺静脉以右肺静脉最常见,PAPVD临床漏诊的主要原因:一是此病常伴有ASD,临床上PAPVD较难与单纯ASD相鉴别,二是术前心脏起超检查很易漏诊,三是常见的,简单的心脏畸表手术中为有常规心内探查而造成漏诊,结论:PAPVD较少见,但漏诊率高,对该病加深认识,提高警惕是防止漏诊的关键。MRI对肺静脉异位引流有较大
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关 键 词: | 肺静脉 异位引流畸形 先天性心脏病 漏诊 诊断 |
Causes of missed diagnosis of partial anomalous pulmonary venous drainage |
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Abstract: | Objective To discuss the results of missed diagnosis or misdiagnosis of partial anomalous pulmonary venous drainage (PAPVD), increase the accuracy of preoperative diagnosis and prevent fault of operation. Methods From Jan. 1991 to Oct. 1995 15 patients with PAPVD received operation in our hospital. The clinical and operation data of them were analyzed to find the reason of missed diagnosis. Result Only 1 out 15 PAPVD patients got a clear diagnosis before operation, 13 were miss diagnosed, 1 was fault operation. All of them were complicated with atrial septal defect (ASD), 3 were complicated with pulmonary stenosis and 3 with pulmonary hypertension. Most anomalous venous were right pulmonary vein, and mostly drain to right atrium and superior vena cave. The causes of missed diagnosis for this disease were the following: ①PAPVD was often complicated with atrial septal defect. It was difficult to identify PAPVD from simple ASD. ②Preoperative UCG examination was often missed diagnosed.③ A closed intracardiacexploration was not routinely performed in the commonand simple operation of congenital heart disease. Conclusion PAPVD was not seen frequently. But it had a high rate of missed diagnosis. Doctors should be aware of this disease. This is the key to prevent missed diagnosis. MRI has a high diagnostic value to this disease. |
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Keywords: | Pulmonary venous Anomalous drainage Congenital heart defects |
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