肺动静脉瘘的诊断及治疗

1978～1996年．我院手术治疗肺动静脉瘘10例，其中男7例，女3例，平均年龄34（15～52）岁。单发6例，多发4例。主要临床表现为紫绀、红细胞增多症、低氧血症、胸部异常血管杂音及与肺门有粗大血管形相连的肺部阴影。手术适应症为：①所有单发病变；②肺动静脉瘘为体循环供血；③有一种或多种并发症；④肺内存在大量的右向左分流。多发患者手术的选择应首先切除病变最集中的肺叶，其它肺周的小病灶可局部切除。单发患者术后无复发，症状可完全消失；多发患者疗效较差，常需进一步治疗。

DIAGNOSIS AND TREATMENT OF PULMONARY ARTERIOVENOUS FISTULA

10 adult patients with pulmonary arteriovenous fistula received operation in our hospital,includ-ing 7 males and 3 females with age ranging from 15 to 52,of whom 6 cases suffered from solitary fistula and the other 4 from multiple fistula. Characteristic clinical findings were cyanosis, polycythemia, hypoxemia, vascular abnormal murmur in chest and pulmonary hilar shadow. The operation indicated all patients with solitary fistu-la;fistula supplying blood for general circulation;fistula with one or more complications,and fistula with large amount of right-to-left shunt in the lungs. The patients with multiple fistula received lobectomy for the small le-sions in the other lobes- No patients with solitary lesion have experienced recurrence and the symptoms after op-eration disappeared,while those with multiple fistula need further treatment.