• 同濟(jì)大學(xué)附屬上海市肺科醫(yī)院胸外科, 上海 200433;

目的探討肺動(dòng)靜脈瘺的臨床特點(diǎn)、手術(shù)切除及治療效果?！》椒ā』仡櫺苑治鲎?1990年 1月至 2010年 12月同濟(jì)大學(xué)附屬上海市肺科醫(yī)院手術(shù)治療 23例肺動(dòng)靜脈瘺患者的臨床資料，其中男 10例，女 13例；年齡 13～ 49（30.5±4.9）歲。行開(kāi)胸手術(shù) 16例，電視胸腔鏡手術(shù) 7例；肺楔形切除術(shù) 10例，肺葉切除術(shù) 13例。　結(jié)果圍術(shù)期無(wú)死亡， 23例病灶徹底切除，術(shù)后無(wú)肺部感染、胸腔內(nèi)出血、低血壓、氣胸、膿胸及支氣管胸膜瘺等并發(fā)癥。 23例患者手術(shù)后動(dòng)脈血氧分壓較術(shù)前明顯改善［（93.5±2.8）mm Hg vs.（84.1±4.8）mm Hg，P＜ 0.05］。隨訪 23例，隨訪時(shí)間 5～ 56個(gè)月，肺動(dòng)靜脈瘺無(wú)復(fù)發(fā)。　結(jié)論　外科手術(shù)是治療肺動(dòng)靜脈瘺非常有效的手段，對(duì)孤立性病變應(yīng)優(yōu)先考慮行電視胸腔鏡手術(shù)，其具有創(chuàng)傷小、恢復(fù)快等特點(diǎn)。

引用本文： 劉明,姜格寧,丁嘉安. 肺動(dòng)靜脈瘺的外科治療. 中國(guó)胸心血管外科臨床雜志, 2012, 19(2): 205-2074. doi: 復(fù)制

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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, 匡鋒, 周新民, 等. Hybrid 技術(shù)治療左肺動(dòng)靜脈瘺合并重度主動(dòng)脈瓣關(guān)閉不全一例.中國(guó)胸心血管外科臨床雜志, 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, 靳志濤. 雙肺彌漫性肺動(dòng)靜脈瘺一例. 中國(guó)胸心血管外科臨床雜志, 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.
  1. 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. 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. 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. 4. 　Faughnan ME, Lui YW, Wirth JA, et al. Diffuse pulmonary arteriovenous malformations： characteristics and prognosis. Chest, 2000, 117（1）：31-38.
  5. 5. 　伍源, 匡鋒, 周新民, 等. Hybrid 技術(shù)治療左肺動(dòng)靜脈瘺合并重度主動(dòng)脈瓣關(guān)閉不全一例.中國(guó)胸心血管外科臨床雜志, 2010, 17（3） ： 181.
  6. 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. 7. 　白玉蓉, 靳志濤. 雙肺彌漫性肺動(dòng)靜脈瘺一例. 中國(guó)胸心血管外科臨床雜志, 2009, 16（2）： 163.
  8. 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. 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. 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. 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. 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. 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. 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. 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. 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. 17. -37.