儿童先天性心脏缺陷

血管环

血管环是一种出生时即存在的心脏问题，属于先天性心脏缺陷。该病患者体内主要动脉部分或其分支会在气管、食管或二者周围形成一个环。

• 身体的主要动脉被称为主动脉。该病影响主动脉弓这个部分。
• 食管从嘴通向胃，是吞咽食物的管道。
• 气管是主要的呼吸通道。

血管环可能完整，也可能不完整。

• 完整的血管环会在食管和气管周围形成一个环。
• 不完整的血管环不会完全环绕食管或气管。

血管环通常需要手术治疗。

症状

有些血管环患者并没有症状。有时，症状要到年龄较大时才被发现。血管环压迫气管和食管，可能引起呼吸和消化问题。

血管环的症状可能包括：

• 频繁呼吸道感染。
• 哮鸣。
• 咳嗽。
• 吞咽困难。
• 进食困难。
• 呕吐。

一些先天性血管环患者在出生时还可能有其他心脏问题。具体症状取决于心脏问题的类型。

病因

The exact cause of vascular rings is not known. Congenital heart conditions happen as a baby, also called a fetus, is growing in the womb during pregnancy.

Some things that may play a role in the development of congenital heart conditions are:

• Gene changes.
• Some medicines.
• Some health conditions.
• Lifestyle choices, including smoking.
• Things in your environment.

风险因素

What increases the risk of vascular rings is not well known. Possible risk factors for vascular rings and other congenital heart conditions are:

• Genetics. Changes in some genes have been linked to congenital heart conditions. For example, people with Down syndrome often are born with heart conditions.
• Diabetes. Having type 1 or type 2 diabetes during pregnancy may change how the unborn baby's heart forms. But diabetes that develops during pregnancy doesn't typically increase a baby's risk of congenital heart conditions.
• Rubella, also called German measles. Having rubella during pregnancy can cause harmful changes in an unborn baby's heart. A blood test can be done before pregnancy to see if you're immune to rubella. A vaccine is available for people who aren't immune.
• Some medicines. Taking some medicines during pregnancy may increase the risk of congenital heart conditions. Examples include lithium (Lithobid) for bipolar disorder and isotretinoin (Claravis, Myorisan, others), which is used to treat acne. Talk with a healthcare professional about the medicines you take.
• Smoking. If you smoke, quit. Smoking during pregnancy or being around tobacco smoke increases the risk of some congenital heart conditions.
• Alcohol use. Drinking alcohol during pregnancy may increase the risk of heart conditions in the baby.

Types

诊断

医务人员会对您进行体格检查并询问您与症状相关的问题。诊断血管环的检查可能包括：

• 影像学检查。胸部 X 线检查可以显示气管变化，这可能表明血管环的存在。检查还可以显示主动脉弓在身体的哪一侧。

  其他影像学检查可能包括超声心动图、CT 血管造影或 MRI 扫描。医务人员也可能利用这些检查来制定治疗方案。

• 钡餐。这项检查需要吞服钡剂，然后通过 X 线观察钡剂从口腔进入胃的过程。该检测可显示是否存在可能由血管环引起的食管结构变化。
• 上消化道内镜检查。用一根带摄像头的长软管检查食管。这种设备叫做内镜。医务人员把它经口腔插入咽喉。内镜末端的微型摄像头会把图像传输到视频监视器上。
• 支气管镜。在这项检查中，医务人员会将一根小软管经口腔或鼻子插入肺部。医务人员可借助导管上的照明灯和小型摄像头观察气管和肺部气道的内部，这项检查可显示血管环是否挤压气管。

治疗

通常需要手术来治疗压迫气管或食管的血管环。手术也有助于预防并发症。

医务人员在术中切开血管环，使血管不再压迫气管和食管。该手术可能会采用心内直视手术或微创手术的形式完成。

具体手术类型取决于心脏问题的类型。

先天性血管环患者一生都需要定期体检以预防并发症。

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