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华西医学  2013 

儿童先天性腹主动脉瘤一例并文献回顾

DOI: 10.7507/1002-0179.20130500, PP. 1586-1589

Keywords: 主动脉瘤,,先天性,儿童,多层螺旋CT血管成像,手术治疗

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Abstract:

目的 提高对先天性腹主动脉瘤(AAA)的认识。方法 报道2012年11月1日先天性AAA1例,回顾国内外报道的24例先天性AAA的临床资料。结果 患儿男,2岁,以肉眼血尿起病,伴高血压、蛋白尿和反复血小板降低;多层螺旋CT血管成像(MSCTA)见AAA伴左肾动脉狭窄;彩色多普勒超声见AAA累及双侧髂总动脉伴动脉壁间血栓及钙化,左肾萎缩;保守治疗7个月后猝死,临终前头颅CT见脑梗死。回顾分析24例先天性AAA,包括肾下型AAA15例,肾上型AAA5例,胸腹部AAA2例,未具体指明类型2例;产前诊断6例,出生后诊断18例(其中包括新生儿5例和1个月~3岁婴幼儿8例);以腹部搏动性包块起病8例,呕吐4例,呼吸困难2例,腰部疼痛1例,因其他疾病就诊3例;采用血管超声21例,MSCTA16例,磁共振血管造影9例;13例肾下型AAA接受手术治疗;死于AAA破裂5例,死于心力衰竭2例。结论 先天性AAA以肾下型为主,多为婴幼儿,常表现为腹部肿块,确诊该病首选MSCTA,主张行早期个体化手术。

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