肺动静脉瘘的外科治疗_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

刘明 , 姜格宁 , 丁嘉安

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Keywords：

肺动静脉瘘; 　外科手术; 　效果

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目的探讨肺动静脉瘘的临床特点、手术切除及治疗效果。　方法　回顾性分析自 1990年 1月至 2010年 12月同济大学附属上海市肺科医院手术治疗 23例肺动静脉瘘患者的临床资料，其中男 10例，女 13例；年龄 13～ 49（30.5±4.9）岁。行开胸手术 16例，电视胸腔镜手术 7例；肺楔形切除术 10例，肺叶切除术 13例。　结果围术期无死亡， 23例病灶彻底切除，术后无肺部感染、胸腔内出血、低血压、气胸、脓胸及支气管胸膜瘘等并发症。 23例患者手术后动脉血氧分压较术前明显改善［（93.5±2.8）mm Hg vs.（84.1±4.8）mm Hg，P＜ 0.05］。随访 23例，随访时间 5～ 56个月，肺动静脉瘘无复发。　结论　外科手术是治疗肺动静脉瘘非常有效的手段，对孤立性病变应优先考虑行电视胸腔镜手术，其具有创伤小、恢复快等特点。

Citation： 刘明,姜格宁,丁嘉安. 肺动静脉瘘的外科治疗. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(2): 205-2074. doi: Copy

1.	Gupta S, Faughnan ME, Bayoumi AM. Embolization for pulmonary arteriovenous malformation in hereditary hemorrhagic telangiectasia： a decision analysis. Chest, 2009, 136（3）：849-858.
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12.	Thung KH, Sihoe AD, Wan IY, et al. Hemoptysis from an unusual pulmonary arteriovenous malformation. Ann Thorac Surg, 2003, 76（5）：1730-1733.
13.	Watanabe N, Munakata Y, Ogiwara M, et al. A case of pulmonary arteriovenous malformation in a patient with brain abscess successfully treated with video-assisted thoracoscopic resection. Chest, 1995, 108（6）：1724-1727.
14.	Litzler PY, Douvrin F, Bouchart F, et al. Combined endovascular and video-assisted thoracoscopic procedure for treatment of a ruptured pulmonary arteriovenous fistula： Case report and review of the literature. J Thorac Cardiovasc Surg, 2003, 126（4）：1204-1207.
15.	Miyoshi K, Moriyama S, Nawa S. Bronchial arteriovenous malformation with large aneurysm, resected by video-assisted thoracic surgery. Gen Thorac Cardiovasc Surg, 2009, 57（3）：162-165.
16.	Hang SY, Zhang ZT, Ou SL, et al. Fistulectomy as a surgical option for pulmonary arteriovenous malformation. Chin Med J（Engl）, 2009, 122（19）：2321-2324.
17.	-37.

1. 　Gupta S, Faughnan ME, Bayoumi AM. Embolization for pulmonary arteriovenous malformation in hereditary hemorrhagic telangiectasia： a decision analysis. Chest, 2009, 136（3）：849-858.
2. 　Georghiou GP, Berman M, Vidne BA, et al. Pulmonary arteriovenous malformation treated by lobectomy.Eur J Cardiothorac Surg, 2003, 24（2）：328-330.
3. 　Kawano H, Hirano T, Ikeno K, et al. Brain abscess caused by pulmonary arteriovenous fistulas without Rendu-Osler-Weber disease. Intern Med, 2009, 48（6）：485-487.
4. 　Faughnan ME, Lui YW, Wirth JA, et al. Diffuse pulmonary arteriovenous malformations： characteristics and prognosis. Chest, 2000, 117（1）：31-38.
5. 　伍源, 匡锋, 周新民, 等. Hybrid 技术治疗左肺动静脉瘘合并重度主动脉瓣关闭不全一例.中国胸心血管外科临床杂志, 2010, 17（3）： 181.
6. 　Ando K, Mochizuki A, Kurimoto N, et al. Coil embolization for pulmonary arteriovenous malformation as an organ-sparing therapy： outcome of long-term follow-up. Ann Thorac Cardiovasc Surg, 2011, 17（2）：118-123.
7. 　白玉蓉, 靳志涛. 双肺弥漫性肺动静脉瘘一例. 中国胸心血管外科临床杂志, 2009, 16（2）： 163.
8. 　Chowdhury UK, Kothari SS, Bishnoi AK, et al. Successful lobectomy for pulmonary arteriovenous malformation causing recurrent massive haemoptysis. Heart Lung Circ, 2009, 18（2）：135-139.
9. 　Nakajima J, Takamoto S, Takeuchi E, et al. Thoracoscopic surgery for pulmonary arteriovenous malformation. Asian Cardiovasc Thorac Ann, 2006, 14（5）：412-415.
10. 　Ishikawa Y, Yamanaka K, Nishii T, et al. Video-assisted thoracoscopic surgery for pulmonary arteriovenous malformations： report of five cases. Gen Thorac Cardiovasc Surg, 2008, 56（4）：187-190.
11. 　Nakamura H, Miwa K, Haruki T, et al. Pulmonary arteriovenous fistula with cerebral infarction successfully treated by video-assisted thoracic surgery. Ann Thorac Cardiovasc Surg, 2008, 14 （1）：.
12. 　Thung KH, Sihoe AD, Wan IY, et al. Hemoptysis from an unusual pulmonary arteriovenous malformation. Ann Thorac Surg, 2003, 76（5）：1730-1733.
13. 　Watanabe N, Munakata Y, Ogiwara M, et al. A case of pulmonary arteriovenous malformation in a patient with brain abscess successfully treated with video-assisted thoracoscopic resection. Chest, 1995, 108（6）：1724-1727.
14. 　Litzler PY, Douvrin F, Bouchart F, et al. Combined endovascular and video-assisted thoracoscopic procedure for treatment of a ruptured pulmonary arteriovenous fistula： Case report and review of the literature. J Thorac Cardiovasc Surg, 2003, 126（4）：1204-1207.
15. 　Miyoshi K, Moriyama S, Nawa S. Bronchial arteriovenous malformation with large aneurysm, resected by video-assisted thoracic surgery. Gen Thorac Cardiovasc Surg, 2009, 57（3）：162-165.
16. 　Hang SY, Zhang ZT, Ou SL, et al. Fistulectomy as a surgical option for pulmonary arteriovenous malformation. Chin Med J（Engl）, 2009, 122（19）：2321-2324.
17. -37.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

肺动静脉瘘的外科治疗

Abstract Full text Figures/Tables Video References Cited by

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