本文選題：支氣管囊腫 + 臨床表現(xiàn)��； 參考：《廣西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：分析支氣管囊腫確診病例的診斷和治療情況,總結(jié)其臨床資料特點(diǎn),為支氣管囊腫的診治工作提供參考。 方法：回顧性分析我院2003年3月至2012年3月共9年來(lái)的14例經(jīng)手術(shù)及病理證實(shí)的支氣管囊腫患者的臨床表現(xiàn)、影像學(xué)資料、病理學(xué)資料及治療方法,并結(jié)合國(guó)內(nèi)外文獻(xiàn)進(jìn)行討論。 結(jié)果：①男女比例1：1,年齡17-65歲,平均年齡(39.6±14.7)歲,其中青年人(18-45歲)7例(7/14)。②臨床特征：胸痛(8/14),咳嗽(5/14)、呼吸困難(5/14)為最常見(jiàn)臨床癥狀,14例均無(wú)發(fā)熱、盜汗、消瘦、乏力等全身癥狀,無(wú)癥狀因體檢發(fā)現(xiàn)者4例(4/14)。③影像學(xué)特征：縱隔型共12例,肺內(nèi)型2例；縱隔型中以后縱隔(7/12)及上縱隔(4/12)多見(jiàn)。14例均表現(xiàn)為單發(fā)類圓形囊性病灶,囊壁厚度集中在1-5mm之間,邊緣光整薄壁囊腫,無(wú)分葉、密度不均、毛刺,無(wú)浸潤(rùn)影、胸膜凹陷征、周圍毛玻璃影等表現(xiàn)。囊腫內(nèi)水樣密度者(9/14)多見(jiàn),其次為軟組織密度影(2/12)與氣性空洞(2/12)。增強(qiáng)掃描后3例囊壁輕度強(qiáng)化(3/10)。④血清學(xué)特點(diǎn)和器械檢查：2例術(shù)前血常規(guī)白細(xì)胞及中性粒細(xì)胞比值增高,術(shù)后抗感染后復(fù)查恢復(fù)正常范圍,余病例血清學(xué)檢查無(wú)異常。1例患者腹部超聲提示合并肝囊腫。1例合并左腎囊腫。11例患者行肺功能檢查均無(wú)明顯異常。⑤病理學(xué)特點(diǎn)：14例均為單個(gè)囊性包塊,單房12例(12/14),多房2例(2/14)；光學(xué)鏡下,14例(14/14)囊壁組織均發(fā)現(xiàn)假?gòu)?fù)層纖毛柱狀上皮、平滑肌、纖維組織及漿液性或粘液性腺體,6例(6/14)發(fā)現(xiàn)軟骨,2例(2/14)見(jiàn)炎癥細(xì)胞。⑥治療及預(yù)后：14例患者均經(jīng)外科手術(shù)治愈,隨訪無(wú)異常。 結(jié)論①支氣管囊腫屬于先天性少見(jiàn)病,病程長(zhǎng)短不一,進(jìn)展緩慢。 ②支氣管囊腫最常見(jiàn)呼吸道癥狀為輕微胸痛、咳嗽及呼吸困難,而發(fā)熱等全身癥狀少見(jiàn)。部分患者可無(wú)癥狀。 ③影像學(xué)表現(xiàn)為縱隔或肺內(nèi)孤立的、邊緣光整、密度均勻薄壁水樣囊性腫塊,以縱隔型多見(jiàn)。易誤診為縱隔神經(jīng)源性腫瘤、肺大泡、肺膿腫、肺曲菌病等。 ④組織病理學(xué)鏡下見(jiàn)囊壁內(nèi)襯假?gòu)?fù)層纖毛柱狀上皮,囊壁含成熟軟骨、支氣管平滑肌、粘液或漿液腺體細(xì)胞等為確診依據(jù)。 ⑤手術(shù)治療效果好,預(yù)后好。
[Abstract]:Objective: to analyze the diagnosis and treatment of bronchial cysts, and to summarize the clinical data and provide reference for the diagnosis and treatment of bronchial cysts. Methods: the clinical manifestations, imaging data, pathological data and treatment methods of 14 patients with bronchial cyst confirmed by operation and pathology were retrospectively analyzed from March 2003 to March 2012. And combined with the domestic and foreign literature to discuss. Results the ratio of 1: 1 to 1: 1 was 17-65 years old, with an average age of 39.6 鹵14.7 years. The clinical features of 7 / 7 / 14.2 cases of young people aged 18-45 years were as follows: chest pain 8 / 14, cough 5 / 14, dyspnea 5 / 14). The most common clinical symptoms were none of the 14 patients with fever, night sweating, wasting, fatigue and other systemic symptoms. The imaging features of 4 cases of asymptomatic finding due to physical examination were as follows: mediastinal type 12 cases, intrapulmonary type 2 cases, mediastinal type 7 / 12) and superior mediastinum 4 / 12). 14 cases showed single round cystic lesions, and the thickness of cystic wall was concentrated between 1-5mm. Thin-wall cysts, without lobes, uneven density, burr, no infiltrating shadow, pleural indentation, perivitreous shadow and so on. Water density in cysts was 9 / 14), followed by soft tissue density (2 / 12) and air cavity (2 / 12). The serological characteristics of 3 / 10 / 10.4 cases with mild enhancement of cystic wall after enhanced scanning and the instrument examination showed that the ratio of white blood cell and neutrophil increased in 2 cases before operation, and returned to normal range after anti-infection after operation, and the ratio of leukocyte and neutrophil was increased in 2 cases before and after operation. There was no abnormality in serological examination in the remaining cases. 1 cases of liver cysts were diagnosed by abdominal ultrasound. 1 case with left renal cysts. All 14 cases were single cystic mass with no obvious abnormal 5. 5 pathological features of pulmonary function examination. 12 / 14 of monocyst, 2 / 14 / 14 of multiloculars, 14 / 14 of 14 / 14 / 14 of cysts under optical microscope, all of them showed pseudo-lamellar cilia columnar epithelium and smooth muscle. 6 cases of fibrous tissue and serous or mucinous glands 6 / 14) 2 cases of chondrosis were found 2 / 14) inflammatory cell .6 treatment and prognosis of 14 cases were cured by surgical operation and no abnormal follow-up was observed. Conclusion 1 bronchial cyst is a rare congenital disease with different duration and slow progression. 2 the most common respiratory symptoms of bronchial cyst are mild chest pain, cough and dyspnea, but fever is rare. Some patients are asymptomatic. 3 the imaging findings were solitary mediastinal or intrapulmonary, smooth margin, homogeneous thin-wall water-like cystic mass, mediastinal type. Easily misdiagnosed as mediastinal neurogenic tumor, alveoli, pulmonary abscess, pulmonary aspergillosis, etc. 4 under histopathological examination, pseudostratified ciliated columnar epithelium was found in the cyst wall. Mature cartilage, bronchial smooth muscle, mucous or serous glandular cells were the basis of diagnosis. 5 the effect of operation is good and the prognosis is good.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R562.2

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本文編號(hào)：1931354