儿童先天性肺动脉吊带的临床特征:附27例分析  

Clinical features of pulmonary artery sling in children:a report of 27 cases

作　　者：黄斌[1] 张丽 袁家 黄萍 虢艳 徐文彪 龚芳 

机构地区：[1]广东省潮州市中心医院儿科,广东潮州515634 [2]广州市妇女儿童医疗中心心内科,广州510623 [3]广州市妇女儿童医疗中心放射科,广州510623

出　　处：《岭南心血管病杂志》2015年第1期70-73,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨儿童先天性肺动脉吊带的临床特点。方法回顾性分析27例肺动脉吊带患儿的临床资料,总结其临床表现及影像学特点。结果本组患儿27例,其中男13例,女14例;年龄7个月(10 d^6岁);体质量6(1.4~17.4)kg;均有不同程度的呼吸道症状,包括反复咳嗽、喘鸣和气促;14例患儿在心前区可闻及收缩期杂音。胸部平片检查19例提示为支气管肺炎,3例为支气管炎,5例未见异常。经二维彩色多普勒超声心动图诊断23例,心脏多层螺旋计算机断层扫描诊断27例。21例合并其他心血管畸形,其中2例伴室间隔缺损,5例合并房间隔缺损,3例合并动脉导管未闭,3例合并永存左上腔静脉,1例合并二尖瓣关闭不全,1例合并迷走右锁骨下动脉,6例合并多发心脏畸形;19例合并气管畸形。24例患儿行肺动脉吊带矫治术和(或)合并心内畸形矫治术,其中3例术后死亡。另3例患儿术前均因肺炎进展快、呼吸衰竭死亡。结论肺动脉吊带的临床表现缺乏特异性,若临床上出现无法解释的呼吸道梗阻症状,应警惕该病的可能。采用各种检查方法如二维彩色多普勒超声心动图、心脏多层螺旋计算机断层扫描、心血管造影等以明确诊断,使患儿得到及时、有效的治疗,能降低病死率。Objectives To investigate the clinical and angiographic features of pulmonary artery sling in children.Methods We retrospectively analyzed the clinical data of 27 cases with pulmonary artery sling. The clinical features and the image data of pulmonary artery sling were summarized. Results Our patient cohort included 27 patients with pulmonary artery sling,consisting of 13 males and 14 females. Their age ranged from 10 days to 6 years（ median age7 months）,and their weight ranged from 1.4 kg to 17.4 kg（median weight 6 kg）. All the patients had respiratory symptoms including persistent cough,stridor and anhelation. Physical examination showed heart murmurs in 14 patients.Chest-X-ray showed pneumonia in 19 patients,bronchitis in 3 patients and 5 patients were normal. Twenty-three patients were diagnosed as pulmonary artery sling by two-dimensional color Doppler echocardiography and 27 by multidetector-row computed tomography（MDCT）. Of the 21 patients combined with cardiovascular abnormalities,2 were with ventricular septal defect,5 with atrial septal defect,3 with patent ductus arteriosis,3 with persistent left superior vena cava,1 with mitral insufficiency,1 with vagus at the right subclavian artery,6 with multiple cardiac abnormalities.Nineteen patients were combined with tracheal deformity. Twenty-four patients underwent surgical repair of pulmonary artery sling and（or） cardiac surgery. After surgery,3 patients were death. Three patients died of respiratory failure caused by pneumonia before surgery. Conclusions The clinical features of pulmonary artery sling are lack of specificity.Once airway obstruction symptoms are noticed,this disease should be considered. Two-dimensional color Doppler echocardiography,MDCT and cardiac angiography can make a diagnosis of pulmonary artery sling at the early phase. The application of examinations is of important value in these patients. They can achieve timely and effective treatments and reduce the mortality.

关 键 词：心脏缺损 先天性 肺动脉吊带 临床特征 

分 类 号：R541.7[医药卫生—心血管疾病]