李佳?林宇?林冬群?赵青武?黄伯湘?李永锋?陈记财

    【摘要】主动脉食管瘘(AEF)是一种少见但预后极其凶险的疾病，处理不及时可引起严重感染和上消化道大出血。国内报道以食管异物引发的AEF常见，而国外报道则以大动脉疾病手术和主动脉瘤导致的AEF为主。该文报道1例胸主动脉瘤致AEF病例，患者为74岁男性，因降主动脉穿透性溃疡并假性动脉瘤破裂行主动脉支架植入术，术后发生AEF，并出现纵隔感染，在病情稳定后再次出现食管瘘口扩大及消化道出血，虽经积极抢救，但终因失血性休克死亡。临床上遇到有AEF高危因素和典型症状的患者应及早诊断，对于症状不典型的患者，接诊医师应拓宽诊断思路，提高警惕性，实施主动脉支架植入术后应注重广谱抗生素的应用，积极治疗纵隔感染。

    【关键词】主动脉瘤;主动脉食管瘘;主动脉支架植入术;失血性休克;抗感染

    Aortoesophageal fistula induced by thoracic aortic aneurysm： report of one case Li Jia， Lin Yu， Lin Dongqun， Zhao Qingwu， Huang Boxiang， Li Yongfeng， Chen Jicai. Department of Thoracic and Cardiovascu-lar Surgery， Guangdong Provincial Hospital of Chinese Medicine， Guangzhou 510120， China

    Corresponding author， Li Jia， E-mail： ljxy1981@ 163. com

    【Abstract】Aortoesophageal fistula (AEF) is a rare and potentially fatal disease with poor prognosis. Without immediate treatment， AEF may cause severe infection and massive hemorrhage in the upper gastrointestinal tract. Foreign body in the esophagus is the most common cause of AEF in domestic reports ......