3例表现为突发大咯血的肺血管畸形  

Three Cases of Pulmonary Arteriovenous Malformation Manifested by Massive Hemoptysis

作　　者：武敏 王宇清[1] 郝创利[1] 蒋吴君[1] 陈赛男 徐雪云 Wu Min;Wang Yuqing;Hao Chuangli;Jiang Wujun;Chen Sainan;Xu Xueyun(Children’s Hospital of Soochow University,Jiangsu Suzhou 215003,China)

机构地区：[1]苏州大学附属儿童医院,江苏苏州215003

出　　处：《儿科药学杂志》2023年第10期40-44,共5页Journal of Pediatric Pharmacy

摘　　要：目的:总结3例以突发大咯血为表现的肺血管畸形患儿的病例资料,加强对儿童肺血管畸形的早期识别。方法:回顾性分析苏州大学附属儿童医院收治的3例因先天性肺血管畸形导致的大咯血患儿的临床表现、实验室检查、影像学、纤维支气管镜下表现、治疗方法及转归。结果:3例患儿均为年长儿,既往体健,以大咯血为首发症状,除轻微咳嗽外,无其他伴随症状,常规实验室检查无特异表现,3例患儿均通过肺血管造影(DSA)检查确诊;第1例患儿放弃支气管栓塞治疗,后随访因再次大咯血死亡,第2例患儿行介入栓塞治疗,第3例患儿行2次支气管动脉栓塞治疗,第2例和第3例患儿出院随访2年,均未再出现咯血,无不适症状。结论:肺血管畸形多见于年长儿童,平素体健,以突发大咯血为主要表现,无其他伴随症状,及时行DSA检查可明确诊断,应用介入栓塞治疗创伤小,预后良好。Objective:To summarize three cases of pulmonary ateriovenous malformation manifested by massive hemoptysis,so as to improve early recognition of pulmonary ateriovenous malformation in children.Methods:Retrospective analysis was conducted on clinical manifestations,laboratory examinations,imaging,fiberoptic bronchoscopy,treatment methods and outcomes of three cases of pediatric pulmonary arteriovenous malformation manifested by massive hemoptysis admitted into Children’s Hospital of Soochow University.Results:Three cases were older children with no past medical history,presented with hemoptysis as the first symptom,with only mild cough and no other accompanying symptoms.Routine laboratory examinations showed no specific findings.The diagnosis was confirmed in three cases through pulmonary digital subtraction angiography(DSA).The first case opted out of bronchial embolization treatment and eventually died due to recurrent massive hemoptysis.The second case underwent interventional embolization treatment,and the third case received bronchial artery embolization for twice.The second and third cases had been followed up for two years,with no recurrence of hemoptysis and no discomfort.Conclusion:Pulmonary arteriovenous malformation is mostly seen in older children,who are physically fit,with massive hemoptysis as the main manifestation,without other accompanying symptoms,timely DSA examination can make the clear diagnosis,and interventional embolization is minimally invasive with favorable prognosis.

关 键 词：咯血 肺血管畸形 儿童 

分 类 号：R725.6[医药卫生—儿科]