肺隔离症的诊断和治疗

Abstract

目的 探讨肺隔离症的临床特点及外科治疗方法.方法 回顾性分析1998年6月至2008年7月北京大学第一医院胸外科收治的35例经手术、病理证实肺隔离症患者的临床资料.结果 35例肺隔离症患者中叶内型29例,叶外型6例,全部29例叶内型肺隔离症患者均有症状,主要症状为反复咳嗽,咳脓痰,低热及咯血,而6例叶外型者无任何症状.术前确诊23例,主要诊断手段为胸部增强CT扫描,CT血管造影(CTA)及选择性动脉造影.本组所有病例均行手术治疗,术后恢复顺利,无手术死亡.结论 肺隔离症临床表现无特异性,选择性动脉造影对本病的确诊有决定性意义,但为有创检查.CT增强扫描,CTA等非侵袭性血管成像技术已成为选择性动脉造影的重要手段.手术是肺隔离症的最佳治疗方案.

Objective To explore the clinical manifestations and treatment of pulmonary sequestration. Methods Thirty-five patients with pulmonary sequestration confirmed by pathological studies were analyzed. Results Among these patients, 29 were of intralobar type and 6 of extralobar type. All patients of intralobar type had symptoms of cough, expectoration, fever and hemoptysis while 6 cases of extralobar type were asymptomatic. Twenty-three cases were diagnosed preoperatively by enhanced CT scan,CT angiography or selective arteriography. Success of operation had been achieved in all cases. Conclusion The clinical manifestations of pulmonary sequestration are non-specific. Though invasive, selective arteriography plays a decisive role in the diagnosis. Such non-invasive angiographies as enhanced CT scan and CT angiography have become important supplements to it. Once the diagnosis is confirmed, operation should be performed.