胸腔病例（三六六）肺動靜脈畸形

10.6666/ClinMed.202005_85(5).0056

吳佳儒；江起陸

肺動靜脈畸形（pulmonary arteriovenous malformation, PAVM） ； 肺動靜脈廔管（pulmonary arteriovenous fistula） ； 肺動靜脈瘤（pulmonary arteriovenous aneurysm, PAVA） ； 遺傳性出血性血管擴張症（hereditary hemorrhagic telangiectasis, HHT）

臨床醫學月刊

85卷5期（2020 / 05 / 29）

316 - 321

繁體中文

肺動靜脈畸型（pulmonary arteriovenous malformation, PAVM）是肺動脈與肺靜脈直接吻合，而不經過肺部微血管的罕見血管性交通疾病，屬於右至左心血管分流的一種。此種疾病大多無症狀表現，但少數患者有低血氧、喘、咳血等症狀，或產生奇異栓塞（paradoxical emboli）造成腦中風、腦膿瘍。肺動靜脈畸型好發於女性，根據成因可分為與遺傳性出血性血管擴張症相關、後天疾病相關及不明原因導致。心血管分流最好的篩檢工具是胸前顯影劑增強心臟超音波檢查，若高度懷疑肺部動靜脈畸形且具高度分流，須接受胸部電腦斷層檢查及血管攝影評估是否需栓塞治療。本文介紹一名老年男性因慢性咳嗽症狀而診斷出肺動靜脈畸型的案例。

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