儿童血管相关性咯血介入治疗的临床评价

发布时间：2018-07-09 22:51

本文选题：咯血 + 血管　；参考：《临床儿科杂志》2017年01期

【摘要】：目的探讨儿童血管相关性咯血的临床特点及围术期程序性诊治方法。方法回顾性分析16例血管相关性咯血患儿的临床资料及影像学特点,并对其治疗方案及治疗效果进行随访和评价。结果 16例患儿中男4例、女12例,1岁3例、5~13岁13例。经血管造影明确为主肺侧支循环13例(81.25%)、肺动静脉瘘1例(6.25%)、支气管动脉肺血管瘘1例(6.25%),另1例未明确诊断血管类型。11例患儿行介入封堵治疗,1例行胸腔镜下异常血管结扎术,1例行部分肺叶切除术,3例放弃治疗。11例介入封堵治疗患儿,封堵术后即时造影,2例可见少许分流;3例封堵术1年内咯血复发,均为主动脉侧支循环。2例手术治疗患儿无复发。结论肺血管异常为儿童咯血的主要病因之一,以主肺侧支循环为主要类型,介入封堵仍为儿童血管相关性咯血的一线治疗方案。
[Abstract]:Objective to investigate the clinical features and perioperative procedure of hemoptysis in children. Methods the clinical data and imaging features of 16 children with hemoptysis associated with blood vessels were retrospectively analyzed and their therapeutic schemes and therapeutic effects were followed up and evaluated. Results among the 16 children, 4 were male and 13 were 13 years old. 13 cases (81.25%) of pulmonary collateral circulation, 1 case (6.25%) of pulmonary arteriovenous fistula, 1 case (6.25%) of bronchoarterial pulmonary vascular fistula, and 1 case (6.25%) of bronchoarterial pulmonary vascular fistula were identified by angiography. One case underwent partial lobectomy, 3 cases gave up treatment. 11 cases were treated with interventional closure. There were 3 cases with recurrence of hemoptysis within one year after occlusion in 2 cases. All cases were treated with aortic collateral circulation and 2 cases had no recurrence. Conclusion Pulmonary vascular abnormalities are one of the main causes of hemoptysis in children, and the main pulmonary collateral circulation is the main type. Interventional closure is still the first line treatment for hemoptysis related to blood vessels in children.
【作者单位】：重庆医科大学儿童医院心血管内科;重庆儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室重庆市儿童发育重大疾病诊治与预防国际科技合作基地;重庆儿童医院专科心脏彩超室;
【分类号】：R725.4

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