Objective To explore the clinical features,diagnosis and treatment of pulmonary artery sling in infants. Methods From September 2009 to July 2014,patients who were diagnosed as pulmonary artery sling at Childrenˊs Hospital of Chongqing Medical University were recruited and analyzed. The clinical data,imaging examination( X-ray,echocardiography and multi-detector computed tomography scan),bronchoscopy,treatment and surgery were retrospectively reviewed. Results Twenty-nine cases were diagnosed as pulmonary artery sling,including sixteen males and thirteen females with the age at diagnosis ranging from two to forty-two months( median age was seven months). Twenty-six cases manifested with recurrent wheezing and stridor. The chest auscultation of twenty-six patients had wheeze sound. Fifteen cases of children were with simple pulmonary artery sling and the diagnosis of pulmonary artery sling median age was 6 months,the other fourteen cases were accompanied by other cardiovascular diseases,with median age of 8 months with no statistical difference between the two groups( P > 0. 05 ). Twenty-six patients underwent multi-detector CT vascular and airway reconstruction which indentified the diagnosis of pulmonary artery sling and the combinating malformation of heart,another three patients only underwent multi-detector CT airway reconstruction. The CT results showed tracheal stenosis in all patients and found seven bridging bronchus. Twenty-five patients received echocardiography,3 of them were performed before CT scan,but only five patients were indentified with pulmonary artery sling. Thirteen patients received bronchoscopy and were found with tracheal stenosis, six of which were combined with cartilaginous rings. Sixteen patients underwent surgery,but four of them died. After operation,the respiratory symptom of twelve patients was improved. The duration of mechanical ventilation >72 hours,operation age ≤ 5 months or cardiopulmonary bypass time >100 minutes significantly influenced mortality(P<0. 05). Conclusion The infants who had respiratory symptoms such as recurrent wheezing,stridor and respiratory infection with poor effective medical treatment should be evaluated by multi-detector CT to identify pulmonary artery sling and airway abnormalities. Combined with cardiovascular abnormality could help early detection of pulmonary artery sling. patients with respiratory symptom should be treated with surgery to improve tracheal stenosis as early as possible,and a significant portion of patients may not need tracheal surgery. The duration of mechanical ventilation > 72 hours, operation age≤ 5 months or cardiopulmonary bypass time >100 minutes were significantly associated with mortality.%目的：分析婴幼儿肺动脉吊带（ pAS）的临床特征、诊断及治疗。方法回顾性分析2009年9月至2014年7月在重庆医科大学附属儿童医院诊断为pAS的病例，分析其一般情况、临床特征、影像学检查、诊断、治疗和预后。结果29例pAS患儿进入分析，男16例，女13例，诊断pAS时年龄2月龄至3.5岁，中位年龄为7月龄。25例有反复喘息症状，26例入院时肺部听诊可闻及哮鸣音。15例为单纯pAS，确诊pAS中位年龄为6月龄；余14例伴有其他心血管病变，确诊pAS的中位年龄为8月龄，与单纯pAS患儿比较差异无统计学意义（P>0.05）。26例患儿行增强CT心血管重建+气道重建明确pAS及合并先天性心脏畸形诊断，余3例心脏超声提示pAS，增强CT仅行气道重建检查；29例CT检查均提示气道狭窄，合并支气管桥7例。25例行心脏彩超检查，其中13例检查时间早于增强CT心血管重建，5例确诊为pAS。13例行纤维支气管镜检查均发现气管狭窄，其中6例存在气管软骨环。16例行手术治疗，其中12例手术成功，4例死亡。单因素分析显示，有机械通气时间>72 h、手术时年龄≤5月龄或体外循环时间>100 min等因素的pAS患儿病死率高（ P<0.05）。结论对反复喘息发作内科治疗效果不佳的婴幼儿，需警惕pAS的可能，合并心血管畸形并不能帮助早期发现pAS。增强CT心血管重建+气道重建检查可发现pAS及伴随气道畸形，有呼吸道症状者应尽早手术治疗，多数患儿的气道畸形不需手术处理。机械通气时间>72 h、手术时年龄≤5月龄或体外循环时间>100 min与pAS患儿病死率相关。
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