儿童先天性腹主动脉瘤一例并文献回顾_《华西医学》

作者：

张德双 ^1,2 , 王亚妹 ¹ , 陈娟 ¹ ,  陶于洪 ¹

1 四川大学华西第二医院儿科（成都，610041）; 2 泸州医学院附属医院新生儿科;

关键词：

主动脉瘤，腹先天性儿童多层螺旋CT血管成像手术治疗

DOI：

10.7507/1002-0179.20130500

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

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AAA 1 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AAA 15 例，肾上型AAA 5例，胸腹部AAA 2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，MSCTA 16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。

引用本文： 张德双,王亚妹,陈娟,陶于洪. 儿童先天性腹主动脉瘤一例并文献回顾. 华西医学, 2013, 28(10): 1586-1589. doi: 10.7507/1002-0179.20130500 复制

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14.	Malikov S, Delarue A, Fais PO, et al. Anatomical repair of a congenital aneurysm of the distal abdominal aorta in a newborn[J]. J Vasc Surg, 2009, 50(5): 1181-1184.
15.	Cantinotti M, Luchi C, Assanta N. Prenatal diagnosis of abdominal aortic aneurysm[J]. Pediatr Cardiol, 2010, 31(1): 155-156.
16.	Tsunematsu R, Shinozaki T, Fukushima K, et al. Congenital abdominal aortic aneurysm with porencephaly: a case report[J]. Fetal Diagn Ther, 2011, 29(3): 248-252.
17.	Ye C, Yin H, Lin Y, et al. Abdominal aorta aneurysms in children: single-center experience of six patients[J]. Ann Thorac Surg, 2012, 93(1): 201-205.
18.	McAteer J, Ricca R, Johansen KH, et al. Extensive congenital abdominal aortic aneurysm and renovascular disease in the neonate[J]. J Vasc Surg, 2012, 55(6): 1762-1765.
19.	成华, 刘云召. 小儿腹主动脉瘤合并马蹄肾畸形1例[J]. 中国实用儿科杂志, 2004, 19(9): 524.
20.	薛洁皓. 小儿巨大腹主动脉瘤1例[J]. 中华胸心血管外科杂志, 2003, 19(4): 247.
21.	喻茂彬, 杨志辉. 先天性腹主动脉瘤1例[J]. 中国冶金工业医学杂志, 2007, 24(3): 384.
22.	黄小勇, 黄连军, 濮欣, 等. 多排螺旋CT血管成像多种重建方法在腹主动脉瘤术前影像学评估中的应用[J]. 介入放射学杂志, 2011, 20(6): 482-486.
23.	景在平, 陆清声. 腹主动脉瘤的治疗进程[J]. 中华外科杂志, 2011, 49(10): 865.
24.	Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovascular repair of ruptured abdominal aortic aneurysms: systematic literature review[J]. Vascular, 2008, 16(4): 219-224.
25.	Steinke TM, Reber PU, Hakki H, et al. Haematuria and an abdominal aortic aneurysm--warning of an aortocaval fistula[J]. Eur J Vasc Endovasc Surg, 1999, 18(6): 530-531.
26.	苏宏斌, 周兴立, 郭曙光, 等. 血管内支架置入术治疗腹主动脉瘤合并左肾动脉狭窄一例[J]. 中国现代普通外科进展, 2009, 12(2): 166-167.

1. 　Howorth MB Jr. Aneurysm of abdominal aorta in the newborn infant. Report of case[J]. N Engl J Med, 1967, 276(20): 1133-1134.
2. 　Buddingh KT, Zeebregts CJ, Tilanus ME, et al. Large neonatal thoracoabdominal aneurysm: case report and review of the literature [J]. J Pediatr Surg, 2008, 43(7): 1361-1364.
3. 　Dittrick K, Allmendinger N, Wolpert L, et al. Calcified abdominal aortic aneurysm in a 12-year-old boy[J]. J Pediatr Surg, 2002, 37(9): E24.
4. 　Kim JI, Lee W, Kim SJ, et al. Primary congenital abdominal aortic aneurysm: a case report with perinatal serial follow-up imaging[J]. Pediatr Radiol, 2008, 38(11): 1249-1252.
5. 　Odagiri S, Yoshida Y, Kawahara H, et al. Abdominal aortic aneurysm in a 3-year-old child: a case report and review of the Japanese-language literature[J]. Surgery, 1989, 106 (3): 481-485.
6. 　Saad SA, May A. Abdominal aortic aneurysm in a neonate[J]. J Pediatr Surg, 1991, 26(12): 1423-1424.
7. 　Mehall JR, Saltzman DA, Chandler JC, et al. Congenital abdominal aortic aneurysm in the infant: case report and review of the literature[J]. J Pediatr Surg, 2001, 36(4): 657-658.
8. 　Malee MP, Carr S, Rubin LP, et al. Prenatal ultrasound diagnosis of abdominal aortic aneurysm with fibrotic occlusion in aortic branch vessels[J]. Prenat Diagn, 1997, 17(5): 479-482.
9. 　Kim ES, Caiati JM, Tu J, et al. Congenital abdominal aortic aneurysm causing renovascular hypertension, cardiomyopathy, and death in a 19-day-old neonate[J]. J Pediatr Surg, 2001, 36(9): 1445-1449.
10. 　Laing AJ, Hussey AJ, Joyce MR, et al. Ruptured abdominal aortic aneurysm in a 12-month-old boy[J]. J Pediatr Surg, 2002, 37(8): 1234-1235.
11. 　Bell P, Mantor C, Jacocks MA. Congenital abdominal aortic aneurysm: a case report[J]. J Vasc Surg, 2003, 38(1): 190-193.
12. 　Cheung SC, Khong PL, Chiu W, et al. Congenital abdominal aortic aneurysm and renal dysplasia[J]. Pediatr Radiol, 2004, 34(10): 827-830.
13. 　Meyers RL, Lowichik A, Kraiss LW, et al. Aortoiliac reconstruction in infants and toddlers: replacement with decellularized branched pulmonary artery allograft[J]. J Pediatr Surg, 2006, 41(1): 226-229.
14. 　Malikov S, Delarue A, Fais PO, et al. Anatomical repair of a congenital aneurysm of the distal abdominal aorta in a newborn[J]. J Vasc Surg, 2009, 50(5): 1181-1184.
15. 　Cantinotti M, Luchi C, Assanta N. Prenatal diagnosis of abdominal aortic aneurysm[J]. Pediatr Cardiol, 2010, 31(1): 155-156.
16. 　Tsunematsu R, Shinozaki T, Fukushima K, et al. Congenital abdominal aortic aneurysm with porencephaly: a case report[J]. Fetal Diagn Ther, 2011, 29(3): 248-252.
17. 　Ye C, Yin H, Lin Y, et al. Abdominal aorta aneurysms in children: single-center experience of six patients[J]. Ann Thorac Surg, 2012, 93(1): 201-205.
18. 　McAteer J, Ricca R, Johansen KH, et al. Extensive congenital abdominal aortic aneurysm and renovascular disease in the neonate[J]. J Vasc Surg, 2012, 55(6): 1762-1765.
19. 　成华, 刘云召. 小儿腹主动脉瘤合并马蹄肾畸形1例[J]. 中国实用儿科杂志, 2004, 19(9): 524.
20. 　薛洁皓. 小儿巨大腹主动脉瘤1例[J]. 中华胸心血管外科杂志, 2003, 19(4): 247.
21. 　喻茂彬, 杨志辉. 先天性腹主动脉瘤1例[J]. 中国冶金工业医学杂志, 2007, 24(3): 384.
22. 　黄小勇, 黄连军, 濮欣, 等. 多排螺旋CT血管成像多种重建方法在腹主动脉瘤术前影像学评估中的应用[J]. 介入放射学杂志, 2011, 20(6): 482-486.
23. 　景在平, 陆清声. 腹主动脉瘤的治疗进程[J]. 中华外科杂志, 2011, 49(10): 865.
24. 　Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovascular repair of ruptured abdominal aortic aneurysms: systematic literature review[J]. Vascular, 2008, 16(4): 219-224.
25. 　Steinke TM, Reber PU, Hakki H, et al. Haematuria and an abdominal aortic aneurysm--warning of an aortocaval fistula[J]. Eur J Vasc Endovasc Surg, 1999, 18(6): 530-531.
26. 　苏宏斌, 周兴立, 郭曙光, 等. 血管内支架置入术治疗腹主动脉瘤合并左肾动脉狭窄一例[J]. 中国现代普通外科进展, 2009, 12(2): 166-167.

《华西医学》

儿童先天性腹主动脉瘤一例并文献回顾

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《华西医学》

儿童先天性腹主动脉瘤一例并文献回顾

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