妊娠期肺动静脉畸形1例报告(附文献复习)  

Pulmonary arteriovenous malformations during pregnancy:a case report and review of the literature

作　　者：张蕊[1] 李华军[1] 

机构地区：[1]中日友好医院妇产科,北京100029

出　　处：《中日友好医院学报》2016年第4期221-224,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的：探讨妊娠期特发肺动静脉畸形（PAVMs）的病因、临床表现、诊断与治疗方法。方法：回顾分析妊娠期PAVMs病例的临床资料,并进行相关文献报道的复习。结果：PAVMs发病率约2~3/100000,80%~95%是先天的。随着年龄增长疾病有进展,妊娠和青春期也是发病的诱因。PAVMs临床特征非特异,由于发病原因的不同,病灶大小、分流量、进展阶段而表现不同。症状包括劳力性呼吸困难、胸痛、咯血、无症状、癫痫等;体征包括杂音、杵状指、紫绀等。本例为妊娠期特发弥漫性PAVMs,区别于常见有可见病灶的病例,早期易与肺栓塞或肺部感染相混淆,治疗不能进行常规的血管栓塞方法。本例明确诊断后进行氧疗支持,症状逐渐缓解。结论：应对妊娠期呼吸困难应当提高警惕,考虑少见病发生,避免漏诊误诊及严重并发症。Objective：To review the cause,clinical manifestation,diagnosis and treatment of pulmonary arteriovenous malformations（PAVMs）during pregnancy.Methods：With a literature review,we reported a case of PAVMs during pregnancy.Results：The incidence of PAVMs is about 2-3/100000,male to female ratio is about1：1.5 to 1.8,80% to 95% is innate.With age,disease progression,but also the onset of puberty and pregnancy causes.PAVMs has non-specific clinical features,performance are various depending on the causes.Symptoms include exertional dyspnea,chest pain,hemoptysis,and epilepsy;signs include clubbing,cyanosis etc.This case presented a diffuse pulmonary arteriovenous malformation in pregnancy that should carefully be differentiated from pulmonary embolism and pulmonary infection.Respiratory support should be emphasized as initial efforts,including supplemental oxygen and bedrest.The symptoms were relieved.Conclusion：Regarding dyspnea during pregnancy,rare disease should be considered in differentiation diagnosis.

关 键 词：妊娠 肺动静脉畸形 

分 类 号：R714.25[医药卫生—妇产科学]