婴幼儿肺动脉吊带畸形的诊断与漏误诊分析  

Diagnosis and Analysis of Missed Diagnosis and Misdiagnosis on Malformation of Pulmonary Artery Sling in Infants

作　　者：刘彩霞[1] 马新平[1] 杨志刚[1] 邸金[1] 陈瑞[1] 

机构地区：[1]山西省儿童医院,山西太原030013

出　　处：《山西职工医学院学报》2016年第4期8-10,共3页Journal of Shanxi Medical College for Continuing Education

基　　金：山西省儿童医院项目(201028)

摘　　要：目的：探讨婴幼儿先天性肺动脉吊带畸形的诊断方法,进一步提高该疾病诊断的准确性。方法：回顾性分析2009年7月～2016年3月山西省儿童医院确诊的25例先天性肺动脉吊带畸形的诊断资料,进行系统研究。结果：全组25例患儿中伴有咳嗽、喘息或气促等呼吸系统症状的有20例,伴有消化道症状的1例。合并心内畸形的12例,合并颈部淋巴管瘤1例,合并双主动脉弓畸形1例,合并再生障碍性贫血1例,单纯性肺动脉吊带畸形10例。超声确诊12例,漏诊8例,发现可疑建议CT检查的5例。漏诊和可疑的13例均经心脏大血管螺旋CT检查确诊。全组中经多家医院就诊3次以上才确诊的9例。结论：对于反复合并呼吸道感染或咳喘等症状的患儿,临床医生应注意除外肺动脉吊带畸形;超声科医生应多切面探查肺动脉分叉及左右分支走行,可减少本病的漏诊和误诊;螺旋CT增强扫描和三维重建是诊断肺动脉吊带畸形的可靠方法。Objective： To summarize the diagnostic methods of congenital malformation of pulmonary artery sling and to analyze the causes of missed diagnosis and misdiagnosis in infants. Methods： 25 patients with congenital malformation of pulmonary artery sling diagnosed between July 1st 2009 and March 30 th 2016 in Shanxi Children ＇s Hospital were studied retrospectively. Results： 20 cases in the group had respiratory symptoms such as cough,stridor,or shortness of breath. One case had digestive symptom. 12 cases combined intracardiac anomalies. One case was with cervical lymphangioma. One case combined double aortic arch. One case had aplastic anemia. 10 cases were only with pulmonary artery sling. 12 cases with pulmonary artery sling were diagnosed definitely by echocardiography. The pulmonary artery sling was missed in 8 cases. 5 cases were doubted with pulmonary artery sling by echocardiography and accepted the advice for CT scan. The above 13 cases were all confirmed by spiral CT scan. In the group 9 cases had a definite diagnosis after visiting doctors for 3 times or more in different hospitals. Conclusions： Clinical pediatricians should pay more attention and exclude malformation of pulmonary artery sling in the patients with recurrent respiratory infection or cough and stridor. The ultrasound doctor should explore pulmonary artery bifurcation and around the branches through multiple sections to decrease the rate of missed diagnosis and misdiagnosis. Enhanced CT scanning and three-dimensional reconstruction are reliable diagnostic methods to malformation of pulmonary artery sling.

关 键 词：肺动脉吊带 血管环 反复呼吸道感染 呼吸困难 

分 类 号：R725.4[医药卫生—儿科]