先天性主动脉缩窄的诊断与治疗:附75例报告

为探讨小儿先天性主动脉缩窄的临床特点及治疗方法选择。选取１９８５年１月￣１９９８年１月主动脉缩窄７５例，行左、右心导管及升、降主动脉造影，２３例行心导管主动脉缩窄球囊扩张术。发生反复呼吸道感染４７例，心功能不全４５例，７５例均可在胸骨左缘Ⅱ￣Ⅳ肋间闻及收缩要音。血压，上肢〉下肢６０例，接近１０例，正常５例；股动脉搏动减弱６０例，正常１５例。结果：２３例心导管球囊扩张术中除３例主动脉弓发育不良效果不

Diagnosis and treatment of congenital coarctation of the aorta;A report of 75 cases

In order to explore the clinical characteristics and optimal choice of the treatment in children with coarcta-tion of the aorta(CA), 75 cases, who had received left and right catheterization as well as ascending and decending aortogra-phy, were collected in this study from January, 1985 to January, 1998. In 23 cases of them, balloon angioplasty had been performed for therapeutical purpose. Through data analysis of clinical features in these cases with CA, it was observed to have recurrent respiratory tract infection in 47 cases, cardiac dysfunction in 45 cases, systolic murmur between 2nd - 4th intercostal space along left sternal margin when auscultation in all 75cases, much higher blood pressure of upper extremity than that of lower extremity in 60 cases (nearly equal between blood pressure values of both two extremities in 10 cases and normal in 5 cases) and significantly faible pulsation of femoral artery when palpation in 60 cases(normal in 15 cases). Concerning the treatment of angioplasty, except 3 cases who had to receive a further surgical operation after angioplasty because of the occurrence of postoperative restenosis, all other patients had got a fairly satisfactory clinical results. All these results clearly reveal that significant blood pressure difference between two extremities and cardiac catheterization is of actual diagnostic value. Furthermore, balloon angioplasty particularly shows a definite therapeutic effectiveness in cases with postoperative restenosis and CA of simple septal type.