心血管造影对肺动脉闭锁肺动脉发育情况的评价分析.doc

心血管造影对肺动脉闭锁肺动脉发育情况的评价分析 　　作者：郑战传，杨文平，刘国勇 作者单位：(广西钦州市第二人民医院介入治疗室，广西?钦州?535000 E-mail:zheng02813@163.com) 　　【摘要】 目的 评价分析数字减影血管造影术(DSA)显示肺动脉闭锁合并室间隔缺损的肺动脉发育情况。方法 回顾分析18例肺动脉闭锁合并室间隔缺损患者的临床资料，包括X线平片、心电图、超声心动图和DSA，重点分析DSA对显示肺动脉发育情况的优缺点。结果 DSA采集电影图像显示，所有病例均显示右心室充盈，肺动脉闭锁，正常之右室流出道及肺动脉均未见显影，右心室血流均经室间隔缺损流入左心室充盈，升主动脉均有不同程度扩张，3例肺动脉血供主要由未闭动脉导管供给，其中2例由细小动脉导管供血，左右肺动脉融合并发育较好，可见主肺动脉盲端，1例左肺动脉发育不良，明显变细，且由降主动脉2支细小侧支血管补偿供血于左下肺;2例肺动脉血供由共干完成，其余所有肺动脉血供均来自体-肺侧支血管，其中3例来自升主动脉，8例来自降主动脉，2例来自右头臂干和左锁骨下动脉侧支血管。小体-肺侧支和网状细小血管供血，肺动脉发育细小。结论 DSA能有效显示肺动脉发育情况，主动脉造影能全面了解体-肺侧支血管分布，选择性侧支血管造影术是术前栓塞所必要的。 　　【关键词】 血管造影术，数字减影;肺动脉瓣闭锁;室间隔缺损;体-肺侧支血管 　　Evaluation and analysis of digital subtraction angiography in 　　presenting pulmonary atresia and the development of pulmonary artery 　　ZHENG Zhan-chuan, YANG Wen-ping, Liu Guo-yong 　　(Interventional Treatment Department, The Second Peoples Hospital of Qinzhou City, 　　Qinzhou, Guangxi 535000, China E-mail: zheng02813@163.com) 　　Abstract: Objective To evaluate digital subtraction angiography (DSA) in presenting images of the development of pulmonary arteries that suffering pulmonary atresia associated with ventricular septal defect. Methods The clinical records of 18 patients with pulmonary atresia associated with ventricular septal defect were retrospectively analyzed, the clinical materials including X-ray films, electrocardiogram, echocardiography and images of DSA, focusing on analysis of the advantages and disadvantages of DSA in presenting the development of the pulmonary arteries. Results The collected images of DSA film displayed that all cases have shown right ventricle filling pressure, pulmonary atresia, no presentation for normal right ventricular outflow tract and pulmonary artery, all the blood of right ventricular flowed from ventricular septal defect into the left ventricular filling, the ascending aorta expanded to some degree, the pulmonary blood of 3 cases mainly supplied by patent ductus arteriosus, two of which supplied