中国循证儿科杂志2012，Vol.7Issue(3)：205-209,5.DOI:10.3969/j.issn.1673-5501.2012.03.010
先天性血管环12例诊断与治疗分析
Diagnosis and treatment of congenital vascular ring in 12 cases
崇梅 1贺彦 1李伟 1韩玲 1刘迎龙 1金梅 1顾虹 1程沛 1苏俊武 1耿斌1
作者信息
- 1. 首都医科大学附属北京安贞医院儿童心脏中心,北京,100029
- 折叠
摘要
Abstract
Objective To study the clinical features, diagnosis and treatment of congenital vascular ring. Methods The clinical data(age, gender, age of onset, clinical manliestations, laboratory examinations ), imaging examinations (X-ray, echocardiography and multi-detector CT scan ), pulmonary function, bronchoscopy, diagnostic methods, treatment, surgery according to the pathologic types and follow-up of children identified as congenital vascular rings at Beijing Anzhen Hospital from July 2008 to December 2011 were retrospectively reviewed. Results Twelve cases diagnosed as congenital vascular rings were included into the study, including 3 males and 9 females, aged from 1 month to 21 years ( 7 cases less than 1 year of age ). Two cases were correctly diagnosed at the first hospital visit and 9 cases were misdiagnosed. Eleven cases had a history of recurrent cough and wheezing, 2 cases had difficulty in feeding, 3 cases had cyanosis, 10 cases had heart murmurs and 9 cases had growth retardation. The results of echocardiography were double aorta arch in 4 cases, right aortic arch with left ductus arteriosus in 1 case, pulmonary artery sling in 7 cases. Ten cases were combined with other heart malformations. Ten cases were given multi-detector CT airway reconstruction and showed tracheobronchial stenosis in 9 cases ( 5 cases with trachea, 3 cases with right principle bronchus, 1 case with left principle bronchus ), esophagus stenosis in 2 cases. Two cases were given bronchoscopy to confirm the stenosis of trachea in 1 case, right principle bronchus in 1 case. Seven patients underwent surgery according to the pathologic types including 2 cases of cutting off the small arch, 1 case of cutting off the left patent ductus arteriosus and 4 cases of reimplanting of the left pulmonary artery. One of them died. The respiratory symptoms and growth in 6 cases gradually were improved in 3 to 6 months after operation. Conclusions The children with recurrent respiratory symptoms such as chronic cough and wheeze should be examined for the possible presence of congenital vascular rings. Echocardiography as a noninvasive technique combined with multi-detector CT can clearly show the anatomy of vascular rings. Early surgical management to remove the tracheal stenosis is vital for survival.关键词
先天性/血管环/主动脉双弓/肺动脉吊带/气管狭窄Key words
Congenital/Vascular ring/Double aortic arch/Pulmonary artery sling/Tracheal stenosis引用本文复制引用
崇梅,贺彦,李伟,韩玲,刘迎龙,金梅,顾虹,程沛,苏俊武,耿斌..先天性血管环12例诊断与治疗分析[J].中国循证儿科杂志,2012,7(3):205-209,5.
