中国循证儿科杂志Issue(5)：365-370,6.DOI:10.3969/j.issn.1673-5501.2014.05.008
婴幼儿肺动脉吊带29例临床特征及诊治分析
Diagnosis and treatment of pulmonary artery sling in 29 infants
符跃强 1刘成军 1陈应富 1李静 1胡兰 1许峰 1冯川2
作者信息
- 1. 重庆医科大学附属儿童医院 重症医学科 重庆，410014
- 2. 重庆医科大学附属儿童医院 放射科 重庆，410014
- 折叠
摘要
Abstract
Objective To explore the clinical features,diagnosis and treatment of pulmonary artery sling in infants. Methods From September 2009 to July 2014,patients who were diagnosed as pulmonary artery sling at Childrenˊs Hospital of Chongqing Medical University were recruited and analyzed. The clinical data,imaging examination( X-ray,echocardiography and multi-detector computed tomography scan),bronchoscopy,treatment and surgery were retrospectively reviewed. Results Twenty-nine cases were diagnosed as pulmonary artery sling,including sixteen males and thirteen females with the age at diagnosis ranging from two to forty-two months( median age was seven months). Twenty-six cases manifested with recurrent wheezing and stridor. The chest auscultation of twenty-six patients had wheeze sound. Fifteen cases of children were with simple pulmonary artery sling and the diagnosis of pulmonary artery sling median age was 6 months,the other fourteen cases were accompanied by other cardiovascular diseases,with median age of 8 months with no statistical difference between the two groups( P > 0. 05 ). Twenty-six patients underwent multi-detector CT vascular and airway reconstruction which indentified the diagnosis of pulmonary artery sling and the combinating malformation of heart,another three patients only underwent multi-detector CT airway reconstruction. The CT results showed tracheal stenosis in all patients and found seven bridging bronchus. Twenty-five patients received echocardiography,3 of them were performed before CT scan,but only five patients were indentified with pulmonary artery sling. Thirteen patients received bronchoscopy and were found with tracheal stenosis, six of which were combined with cartilaginous rings. Sixteen patients underwent surgery,but four of them died. After operation,the respiratory symptom of twelve patients was improved. The duration of mechanical ventilation >72 hours,operation age ≤ 5 months or cardiopulmonary bypass time >100 minutes significantly influenced mortality(P<0. 05). Conclusion The infants who had respiratory symptoms such as recurrent wheezing,stridor and respiratory infection with poor effective medical treatment should be evaluated by multi-detector CT to identify pulmonary artery sling and airway abnormalities. Combined with cardiovascular abnormality could help early detection of pulmonary artery sling. patients with respiratory symptom should be treated with surgery to improve tracheal stenosis as early as possible,and a significant portion of patients may not need tracheal surgery. The duration of mechanical ventilation > 72 hours, operation age≤ 5 months or cardiopulmonary bypass time >100 minutes were significantly associated with mortality.关键词
肺动脉吊带/气管狭窄/婴幼儿Key words
pulmonary artery sling/Tracheal stenosis/Infant引用本文复制引用
符跃强,刘成军,陈应富,李静,胡兰,许峰,冯川..婴幼儿肺动脉吊带29例临床特征及诊治分析[J].中国循证儿科杂志,2014,(5):365-370,6.
