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目的探讨小儿先天性肺动脉吊带畸形的临床诊断方法。方法回顾分析广州儿童医院1993~2004年收治的肺动脉吊带畸形的婴幼儿6例,采用X线胸片、超声心动图、CT、心血管造影、磁共振、食管吞钡、支气管镜等方法综合检查,其中4例有手术或尸检资料。结果初诊6例全部漏诊,4例经复查确诊(2例术前确诊),1例在术中发现,另1例由尸检发现。6例中超声心动图检出4例;由临床和超声疑诊为肺动脉吊带畸形,高速螺旋CT(n=4)和心血管造影(n=2)诊断符合率100%。结论婴儿早期即出现反复呼吸困难、喘鸣、肺部感染应考虑先天性肺动脉吊带畸形的可能。CT、心血管造影、超声心动图可明确诊断。
Objective To investigate the clinical diagnosis of congenital pulmonary sling deformity in children. Methods Six cases of infants and young children with pulmonary artery stenosis admitted to Guangzhou Children’s Hospital from 1993 to 2004 were retrospectively analyzed. The results of X-ray, echocardiography, CT, angiography, magnetic resonance imaging, barium swallow for esophagus and bronchoscopy were retrospectively analyzed , 4 cases of surgery or autopsy data. Results Six cases were newly diagnosed as missed, 4 cases were confirmed by review (2 cases were diagnosed preoperatively), 1 case was found during operation and 1 case was found by autopsy. Among the 6 cases, 4 cases were detected by echocardiography. The diagnosis rate of pulmonary artery stenosis was 100% by high-speed spiral CT (n = 4) and cardiovascular angiography (n = 2). Conclusions Infantile dyspnea, wheezing and pulmonary infection should consider congenital pulmonary sling deformity. CT, cardiovascular angiography, echocardiography can confirm the diagnosis.