胸主动脉瘤破裂入左肺1例报告及文献分析  

A case report of aneurysm of thoracic aorta ruptured into left lung and review of relature literatures.

作　　者：车国卫[1] 周清华[1] 张尔永[1] 刘斌[2] 唐小军 傅勇[1] 李贵忠[1] 

机构地区：[1]四川大学华西医院胸心血管外科,成都610041 [2]四川大学华西医院麻醉科,成都610041

出　　处：《中国综合临床》2006年第12期1137-1139,共3页Clinical Medicine of China

摘　　要：目的对胸主动脉瘤破裂入左肺进行回顾性分析,旨在提高对胸主动脉瘤破裂入左肺的早期诊断和治疗的有效性。方法结合1例报告,总结自1990年1月至2005年3月文献报道的胸主动脉瘤破裂入左肺16例病例,根据其有无感染、首发症状、胸主动脉瘤部位、侵入肺叶、手术方法及治疗效果进行分析。结果胸主动脉瘤侵入左肺叶多数病程长,多合并肺部细菌和/或特异性感染,咯血是最常见的首发症状;来源于主动脉弓的瘤多侵入左肺上叶,手术多以全弓或次全弓切除及人工血管置换和左肺上叶切除术为主,而降主动脉瘤多侵入左肺下叶,手术以主动脉瘤切除及主动脉修补或血管置换术和左肺下叶切除为主;若无不可控制的大出血,预后较好。结论胸主动脉瘤切除及人工血管置换术加侵入相应肺叶的切除术是治疗胸主动脉瘤侵入左肺的有效方法。Objective To investigate clinical characteristics, mortality and the early diagnosis and treatment of aneurysm of thoracic aorta ruptured into the left lung. Methods The data of 16 patients of aneurysm of thoracic aorta ruptured into the left lung wcre summarized and analyzed. Results The common primary symptoms included discase process long, with bacteria infection and specific infection in the patients with aneurysm of thoracic aorta rup- tured into the left lung. But the hemoptysis was found to be the primary complaints in aneurysm of thoracic aorta pen- etrating the lung. The arch aneurysm of thoracic aorta usually eroded the upper lobe of left lung, and the key operation manners were total or partial aortic arch replacement with artificial blood vessel and left upper lobectomy. It is necessary to perform combined resection of the aneurysm and a left lower lobectomy under circulatory pulmonary bypass. If there was no aortic wall rupture caused uncontrollable bleeding in the operative course, the patients prognosis would be better. Conclusion It is an cffective method of aneurysmeetomy with left pneumonectomy or lobcctomy to treat aneurysm of thoracic aorta.

关 键 词：胸主动脉瘤破裂 外科手术 

分 类 号：R654.2[医药卫生—外科学]