本文選題：支氣管肺隔離癥 + 體征和癥狀　； 參考：《中國全科醫(yī)學(xué)》2017年36期

【摘要】：背景肺隔離癥是一種罕見的先天性肺發(fā)育異常疾病,臨床誤診率高。目的總結(jié)肺隔離癥的臨床特點(diǎn)、影像學(xué)表現(xiàn)、診斷以及治療體會(huì),以降低誤診率。方法收集2008-01-01至2016-10-01濟(jì)寧醫(yī)學(xué)院附屬醫(yī)院收治并確診的53例肺隔離癥患者的臨床資料,對(duì)其臨床特點(diǎn)、影像學(xué)表現(xiàn)、診斷、治療以及預(yù)后進(jìn)行分析。結(jié)果 53例患者中,臨床表現(xiàn)為咳嗽37例、咯血23例、咳痰20例、發(fā)熱12例、胸悶8例、胸痛6例、無明顯癥狀者9例。病變位于左下肺34例、右下肺17例、左上肺2例。影像學(xué)表現(xiàn)為實(shí)性腫塊影19例,囊狀影16例,不規(guī)則斑片狀影12例,空洞4例,肺不張1例,胸腔積液1例。隔離肺的供應(yīng)血管34例來源于胸降主動(dòng)脈,17例來源于腹主動(dòng)脈,1例來源于胸主動(dòng)脈和膈肌動(dòng)脈,1例來源于腹主動(dòng)脈和左膈上動(dòng)脈。53例患者確診30例,23例出現(xiàn)誤診,誤診率為43.4%;48例行胸腔鏡下肺葉切除術(shù),術(shù)后繼發(fā)肺部感染1例,2例咯血患者行異常動(dòng)脈介入栓塞治療,余3例行對(duì)癥治療。所有手術(shù)患者未再復(fù)發(fā)。結(jié)論肺隔離癥臨床表現(xiàn)無特異性,誤診率高,增強(qiáng)CT和CT血管造影(CTA)是臨床常用的診斷方法,確診后應(yīng)積極手術(shù),胸腔鏡下肺葉切除術(shù)是臨床最有效的治療方法。
[Abstract]:Background Pulmonary sequestration is a rare congenital pulmonary dysplasia with high misdiagnosis rate. Objective to summarize the clinical features, imaging manifestations, diagnosis and treatment of pulmonary sequestration in order to reduce the misdiagnosis rate. Methods the clinical data of 53 patients with pulmonary sequestration admitted to Jining Medical College affiliated Hospital from January 2008 to January 10-January 2016-2016-01 were analyzed. The clinical features, imaging manifestations, diagnosis, treatment and prognosis were analyzed. Results among 53 cases, 37 cases were cough, 23 cases were hemoptysis, 20 cases were expectoration, 12 cases were fever, 8 cases were chest tightness, 6 cases were chest pain, 9 cases were without obvious symptoms. The lesions were located in the left lower lung in 34 cases, the right lower lung in 17 cases, and the left upper lung in 2 cases. Imaging findings included solid mass in 19 cases, cystic shadow in 16 cases, irregular patchy shadow in 12 cases, cavity in 4 cases, atelectasis in 1 case, pleural effusion in 1 case. The supply vessels of isolated lung in 34 cases originated from descending thoracic aorta in 17 cases from abdominal aorta in 1 case from thoracic aorta and diaphragmatic artery from 1 case from abdominal aorta and left superior phrenic artery. The misdiagnosis rate was 43.4% and 48 cases underwent thoracoscopic lobectomy, 1 case of secondary pulmonary infection and 2 cases of hemoptysis were treated with abnormal arterial embolization, the remaining 3 cases were treated with symptomatic therapy. No recurrence occurred in all patients. Conclusion the clinical manifestation of pulmonary sequestration is nonspecific and the misdiagnosis rate is high. Enhanced CT and CT angiography (CTAA) are commonly used in clinical diagnosis and should be operated actively after diagnosis. Thoracoscopic lobectomy is the most effective treatment.
【作者單位】： 濟(jì)寧醫(yī)學(xué)院;濟(jì)寧醫(yī)學(xué)院附屬醫(yī)院呼吸內(nèi)科;
【基金】：山東省醫(yī)藥衛(wèi)生科技發(fā)展計(jì)劃項(xiàng)目(2016WS0176)
【分類號(hào)】：R563

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