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首页 主动脉弓离断的临床x线表现(附7例分析)(Clinical manifestat…

主动脉弓离断的临床x线表现(附7例分析)(Clinical manifestation of rupture of aortic arch (an analysis of 7 cases)).doc

主动脉弓离断的临床x线表现(附7例分析)(Cl…

杨尚贤
2018-04-04 0人阅读 举报 0 0 暂无简介

简介:本文档为《主动脉弓离断的临床x线表现(附7例分析)(Clinical manifestation of rupture of aortic arch (an analysis of 7 cases))doc》,可适用于社会民生领域

主动脉弓离断的临床x线表现(附例分析)(Clinicalmanifestationofruptureofaorticarch(ananalysisofcases))主动脉弓离断的临床x线表现(附例分析)(Clinicalmanifestationofruptureofaorticarch(ananalysisofcases))TheclinicalandXraymanifestationsofinterruptionofaorticarch(casesanalysis)TangYukuanZhangQunLiGuoyeontheopenlandLigongYangXiangtaiAbstractObjectiveToinvestigatethecongenitalaorticarch(IAA)theclinicalXrayfeaturesanddiagnosticvalueofxrayMaterialsandmethods:ananalysisofcases(malecases,femalecases,ageddaystoyears,averageyearsold)byangiocardiography(ACG)and(or)confirmedbysurgeryinchildrenwithIAAclinical,XrayandACGfindingsandtheirrelationshipResultscasesallbelongtoAtype,BandC,wereassociatedwithcardiacanomalies,preoperativeXraydiagnosisofcasesThemainXrayfindingsare:Middletrachea(cases)theaorticnodedisappeared(cases)thelowaorticarchsyndrome(cases)theascendingaortadysplasia(cases)theupperrightsidebranchcirculationoflungandmediastinalvessels(cases)ConclusionXraydiagnosisofIAAhavelimitations,butitiscloselycombinedwiththeclinicaldiagnosis,clinicalandXrayDopplerechocardiography(DE)diagnosticmodecanreducetheerror(missed)diagnosis,diagnosedbyACG,thecontraindicationofangiography,MRcanbeusedtodiagnoseKeywordscongenitalaorticarchradiographyangiocardiographyClinicalXraymanifestationsofinterruptionofaorticarch(Analysisofcases)TangYukuanZhangQunLiGuoye(DepartmentofRadiology,PanyuPeople'sHospitalofGuangdongProvince,Panyu)AbstractObjectiveToinvestigatetheclinicalXraycharacteristicsandthecapabilityofXrayplainfilminthediagnosisofcongenitalinterruptedaorticarch(IAA)MethodsTheclinical,XrayandAngiocardiography(ACG)featuresandtheirinterrelationsinIAAcases(malesandfemaleswithagesrangedbetweendaysandyearsandanaverageofyearswereanalyzedAllcases)retrospectivelywereconfirmedbyACGandorsurgeryResultsAllofthecasesbelongedtotypeA,withouttypeBortypeCAllcaseswereassociatedintracardiacdeformityXrayplainfilmfeatureswere:tracheainthemiddle(cases)theaorticknobdisappeared(cases)"lowarchsign"(cases)thehypoplasticascendingaorta(Casesofbypass)Shadowscirculatorybloodvesselsbesideupperrightmediastinum(cases)ConclusionTherearelimitationsintheXrayplainfilmdiagnosisofIAA,butitwillbehelpfulfordiagnosisincloseclinicaladoptionThediagnosticpatternofclinicalXrayDopplerechocardiogram(DE)maytherateof"decreasemisdiagnosis,DiagnosismaybemadewithACGForpatientswithcontraindicationofangiography,MRmaybeadoptedindiagnosisKeywordsInterruptedaorticarchCongenitalRadiographyAngiocardiographyTheaorticarch(Interruptionoftheaorticarch,IAA)isararecongenitalcardiovascularmalformation,priorheartincidencerateoflessthanofcases,withventricularseptaldefect(VSD),patentductusarteriosus(PDA)causedbyerror(missed)diagnosisThispaperreportscasesofcardiovascularangiography(ACG)and(or)confirmedbysurgeryIAA,Combinedwiththeliteraturereview,theclinicalfeaturesandradiologicalfeaturesofthedisease,inordertoimprovetheunderstandingofthisdiseaseMaterialsandmethodsIncases,malecases,femalecases,ageddaystoyears,averageyearsoldcasesofbirthoccurredshortlyaftershortnessofbreath,casesofearlynoobvioussymptomspatientsattheageofbegantosquatphenomenon,caseshadahistoryofbronchialpneumoniacomplicatedwithheartfailurePhysicalexamination:thedevelopmentofchildrenarerelativelybackward,casesoflipfinger(toe)cyanosis,casesoflowerextremityinupperlimbcasesofupperlimbbloodpressurehigherthanthelowerlimb,casesoflowerextremitybloodpressurewasnotdetected,casesoflowerextremitypulseisweakcasesofleftsternalborderthird~intercostalsmellandIII~IVVIinearlyandmidsystolicregurgitantmurmur(includingcaseswithleftsternalborder~intercostalcontinuousmurmur),casesofonlytoleftparasternalintercostalsmellandII~IIIVIsystolicmurmur,patientswithtremor,casesofbackshouldershoulderareabetweenthequasicontinuousmurmurheardAllcasesofhyperthyroidismP(),A<PMRIwasperformedincases,casesunderwentelectrocardiogramandDopplerechocardiography(DE)examination,caseswereconfirmedbyXray,ACGandcardiaccatheterization,casesconfirmedbysurgeryResultElectrocardiogram:casesofsinustachycardia,casesofrightventricularhypertrophy,casesofatrialhypertrophy,ofwhichcaseswerecomplicatedwithmyocardialstrainandlafbXrayexamination:takenheartradiographs,casesofheartincreasedslightly,casesofmoderatetosevereincreaseinrightventricularenlargement,secondrightatrialenlargement,cardiothoracicratio:~,anaverageofIncasesofaortictypeheart,caseswithmitralregurgitation,otherXraysignsseetablecaseswerepresentedwithVSD(orPDA)andpulmonaryhypertension(pH),casesofIAAdiagnosisThemainXrayscheduleofcasesofIAAperformanceThenumberofcasesofXrayfindingsofXraysignsofthenumberofcasesLungbloodlowaorticarchsyndromeinOntherightsideoflungandmediastinalcollateralcirculationvesselstrachealCenterPulmonaryarterysegmenttosuddenheartshadowislikebigPulmonaryarteryaneurysmwasleftmargindoublearchRightuppermediastinumshadowstraightandnarroworemptyheartshadowislikeheadTheaorticarchdisappearedinribnotchDEandMRIexamination:casesofroutinecardiacDEexamination,casesofIAAwerefound,werefoundcombinedwithVSDandPDA,includingcaseswithendocardialfibroelastosis,casesofincompleteendocardialcushiondefect(ECD)MRIwasperformedincases,casesofIAAandmalformationdiagnosisCardiaccatheterizationandACG:underwentrightheartcatheterization,cathetercanbyPDAtothedescendingaorta(DAO),casesofcatheterintotheleftventriclebyVSD,casesofcatheterintotheleftatriumbyASDcaseswithleftheartcatheterization,catheterweretobesenttotheascendingaorta(AAO),casesofcatheterintothepulmonaryarteryangiographyconfirmedbyPDA,PDA(cm,cm)Leftventricularangiographyincases,rightventricleand(or)casesofpulmonaryarteryangiographyshoweddistaltotheleftsubclavianarterydisruption(Atype)cases(Figure),casesofrecyclingdisplayisnotclear,thediagnosisisnotclear,surgicallyprovedfortypeAcasesofAAOdysplasia,differentdegreesoffine(AAODAO~),casesofnormal,casesshowedmainlybysubclavianarteryandinternalmammaryDAOsystemcomposedofabundantcollateralvessels(Figure)patientsunderwentDAOangiography:DAOgrowthisgood,noobviousexpansion,thetopwasclubbedblindend,edgesmooth,PDAconnectedcaseswithbothrightventricularandpulmonaryarteryangiographyand(or)DAOangiographycanconfirmthediagnosisofIAAandheartmalformation,breakingawayfromthedistanceof~cm,withPDA(~cm)inpatientswithlefttorightshunt,caseswithrighttoleftshuntWithVSD(~cm)incaseswithrighttoleftshunt,casesofbidirectionalshuntFigureFigureAccordingtotheclassificationmethodofCeloriaandPatton,accordingtotheangiographicandsurgicalfindingsincases,allbelongtoAtype,Ctype,BWithPDA,PH(moderatetosevere),caseswithVSD,casesofwhichwithASD,caseswereincompleteECDpatientswerecomplicatedwithVSDinpatientswithaortopulmonaryseptaldefect(APSD),caseswithaorticvalveandmitralvalvestenosiscasesweretreatedbysurgery,aorticreconstructionPDAligation,postoperativecasesrecovered,casesofdeath

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主动脉弓离断的临床x线表现&#40;附7例分析&#41;(Clinical manifestation of rupture of aortic arch &#40;an analysis of 7 cases&#41;)

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