肺静脉狭窄咯血1例并文献复习  

Pulmonary vein stenosis and hemoptysis： a case report and literature review

作　　者：文湘梅 张琪[1] 张景亮 薛庆亮 

机构地区：[1]中国人民解放军兰州总医院呼吸内科,730000

出　　处：《国际呼吸杂志》2017年第24期1888-1891,共4页International Journal of Respiration

摘　　要：目的 分析1例成人肺静脉狭窄咯血患者的临床特征,提高对肺静脉狭窄的认识.方法 分析1例以咯血为首发症状的肺静脉狭窄患者的临床资料.以＂肺静脉狭窄＂为中文关键词,以“pulmonary vein stenosis”和“hemoptysis”为英文关键词分别检索万方数据库、中国知网数据库和Pubmed数据库的相关文献,检索时间截止至2017年4月.结果 患者男性,22岁,因＂咯血9 d＂入院,既往有“先天性心脏病：法络四联征”手术史,最终经CT肺血管成像确诊为先天性左下肺静脉狭窄.共检索到中文文献72篇,英文文献38篇,其中75篇与心房颤动射频消融术后肺静脉狭窄有关,26篇报道先天性肺静脉狭窄或闭锁52例（其中单侧肺静脉闭锁8例）,6篇报道完全性肺静脉异位引流（TAPVC）术后肺静脉狭窄,另有2篇报道其他原因致继发性肺静脉狭窄.结论 肺静脉狭窄是一种罕见的心血管疾患,部分患者以咯血为首发表现;临床以不明原因咯血为主要症状的患者,若既往有先天性心脏病或心房颤动射频消融等病史,应警惕肺静脉狭窄的可能,早期诊断能改善预后.Objective To describe the clinical features of pulmonary venous stenosis and hemoptysis ,and to improve the understanding of pulmonary vein stenosis .Methods A case of pulmonary vein stenosis with hemoptysis as the initial symptom were analyzed .We used ＂Pulmonary vein stenosis＂as the Chinese keywords ,＂pulmonary vein stenosis＂and＂hemoptysis＂as the English keywords to retrieve the literature from Wanfang database ,CNKI database and Pubmed database until April 2017 .Results A 22 years old male patient was admitted to hospital for 9 days with hemoptysis .He had a history of congenital heart disease：tetralogy of Fallot ,and was diagnosed as congenital left lower pulmonary vein stenosis by CT pulmonary angiography .Literature review found 72 Chinese recopts and 38 English recopts ,including 75 recopts of pulmonary vein stenosis after ablation therapy for atrial fibrillation , 26 reports of congenital pulmonary vein stenosis or atresia in 52 cases （ including 8 cases of unilateral pulmonary vein atresia） ,the 6 reports of total anomalous pulmonary venous drainage （ TAPVC） after resection of lung vein stenosis , and 2 report other causes of secondary pulmonary vein stenosis . Conclusions Pulmonary vein stenosis is a rare cardiovascular disease ,some patients with hemoptysis as the first manifestation .Clinical with cryptogenic hemoptysis as the main symptoms of the patients ,if patients with congenital heart disease or atrial fibrillation radiofrequency ablation of pulmonary vein stenosis disease ,should be alert to the possible early diagnosis can improve the prognosis .

关 键 词：肺静脉狭窄 咯血 先天性心脏病 

分 类 号：R543.6[医药卫生—心血管疾病]