临床小儿外科杂志2024，Vol.23Issue(11)：1077-1081,5.DOI:10.3760/cma.j.cn101785-202403024-014
儿童支气管动脉肺动脉瘘的临床特征及介入手术疗效分析
Clinical analysis and interventional assessment of bronchial pulmonary artery fistula in children:a re-port of 20 cases
摘要
Abstract
Objective To summarize the clinical characteristics of bronchial pulmonary artery fistula(BPAF)and evaluate the efficacy of interventional closure.Methods For this retrospective case study,20 children were diagnosed with bronchial pulmonary artery fistula at Hunan Children's Hospital from January 2016 to August 2023.Clinical symptoms and enhanced chest computed tomography(CT)findings were recorded.Ef-ficacy and postoperative recurrence were evaluated.Results The symptoms of hemoptysis occurred(n=17),including mild hemoptysis(n=4),moderate hemoptysis(n=5)and massive hemoptysis(n=8).Among 3 cases of non-hemoptysis,there were hematemesis(n=1),dyspnea(n=1)and Kaposi type hemangioma with"chest wall mass"(n=1).Eleven cases had varying degrees of anemia,including mild anemia(n=3),mod-erate anemia(n=7)and severe anemia(n=1).Enhanced chest CT revealed thickened and tortuous bronchial arteries(n=5).Digital subtraction angiography(DSA)was performed for confirming the diagnosis of right bronchial arterio-pulmonary fistula(n=19)and left bronchial arterio-pulmonary fistula(n=1).Hemorrhagic lesions were located in right upper lobe(n=1),right middle lobe(n=4)and right lower lobe(n=7),mixed right middle/lower lobe(n=2),left lower lobe(n=1)and bilateral lungs(n=2).Sixteen cases received ini-tial interventions.During a follow-up period of 1 to 4 years,there was no recurrence.The outcomes were satisfac-tory;Four cases recurred after initial interventions,3 cases relapsed once and 1 case relapsing 5 times was trea-ted thrice.The last operation was 42 months ago.There was no recurrence.Conclusions Hemoptysis is a ma-jor clinical manifestation of BPAF.Enhanced chest CT is conducive to making a definite diagnosis and DSA is a gold standard of diagnosis.Interventional therapy is both safe and effective and it has a definite efficacy with a certain recurrence rate.关键词
支气管动脉/咯血/介入性/儿童Key words
Bronchial Arteries/Hemoptysis/Interventional/Child引用本文复制引用
张继燕,刘腾,肖政辉,黄文雅,陈艳萍,张瑾,段效军..儿童支气管动脉肺动脉瘘的临床特征及介入手术疗效分析[J].临床小儿外科杂志,2024,23(11):1077-1081,5.基金项目
儿童急救医学湖南省重点实验室(2018TP1028) （2018TP1028）
湖南省卫生健康委科研计划课题(202206013971) Hunan Key Laboratory of Child Emergency Medicine(2018TP1028) （202206013971）
Scientific Research Project of Hunan Provincial Health Commission(202206013971) （202206013971）
