中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2008年
6期
421-424
,共4页
支气管肺隔离症%诊断%治疗
支氣管肺隔離癥%診斷%治療
지기관폐격리증%진단%치료
Bronehopulmonary sequestration%Diagnosis%Therapy
目的 探讨肺隔离症的临床特点,提高肺隔离症临床诊断和治疗水平.方法 回顾性分析1999年1月至2006年12月浙江大学医学院附属第一医院收治的27例经病理证实为肺隔离症患者的临床资料并复习相关文献.结果 27例中,男18例,女9例,年龄11～65岁,平均34岁.病程1个月至20年.主要症状为反复咳嗽、咳痰、低热、咯血、胸闷及胸痛.4例无任何症状.27例肺隔离症患者中叶内型22例,叶外型5例,叶内型常有咳嗽、咳痰、发热、咯血等症状,叶外型多无症状.术前确诊或拟诊20例,主要诊断手段为x线胸片、胸部CT平扫及增强扫描、CT血管造影(CTA)、核磁共振血管造影(MRA)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,随访未见复发.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、CTA和MRA等非侵袭性血管成像技术已成为选择性动脉造影的重要补充手段,手术为最佳治疗方法,介入治疗效果有待进一步研究.
目的 探討肺隔離癥的臨床特點,提高肺隔離癥臨床診斷和治療水平.方法 迴顧性分析1999年1月至2006年12月浙江大學醫學院附屬第一醫院收治的27例經病理證實為肺隔離癥患者的臨床資料併複習相關文獻.結果 27例中,男18例,女9例,年齡11～65歲,平均34歲.病程1箇月至20年.主要癥狀為反複咳嗽、咳痰、低熱、咯血、胸悶及胸痛.4例無任何癥狀.27例肺隔離癥患者中葉內型22例,葉外型5例,葉內型常有咳嗽、咳痰、髮熱、咯血等癥狀,葉外型多無癥狀.術前確診或擬診20例,主要診斷手段為x線胸片、胸部CT平掃及增彊掃描、CT血管造影(CTA)、覈磁共振血管造影(MRA)及選擇性動脈造影.本組所有病例均行手術治療,術後恢複順利,隨訪未見複髮.結論 肺隔離癥臨床錶現無特異性,選擇性動脈造影對本病的確診有決定性意義,但為有創檢查.CT增彊、CTA和MRA等非侵襲性血管成像技術已成為選擇性動脈造影的重要補充手段,手術為最佳治療方法,介入治療效果有待進一步研究.
목적 탐토폐격리증적림상특점,제고폐격리증림상진단화치료수평.방법 회고성분석1999년1월지2006년12월절강대학의학원부속제일의원수치적27례경병리증실위폐격리증환자적림상자료병복습상관문헌.결과 27례중,남18례,녀9례,년령11～65세,평균34세.병정1개월지20년.주요증상위반복해수、해담、저열、각혈、흉민급흉통.4례무임하증상.27례폐격리증환자중협내형22례,협외형5례,협내형상유해수、해담、발열、각혈등증상,협외형다무증상.술전학진혹의진20례,주요진단수단위x선흉편、흉부CT평소급증강소묘、CT혈관조영(CTA)、핵자공진혈관조영(MRA)급선택성동맥조영.본조소유병례균행수술치료,술후회복순리,수방미견복발.결론 폐격리증림상표현무특이성,선택성동맥조영대본병적학진유결정성의의,단위유창검사.CT증강、CTA화MRA등비침습성혈관성상기술이성위선택성동맥조영적중요보충수단,수술위최가치료방법,개입치료효과유대진일보연구.
Objective To explore the clinical manifestations,the diagnosis and the treatment of bronchopulmonary sequestration.Methods Twenty-seven cases of bronchopulmonary sequestration confirmed by histopathological studies were analyzed and related literatures were reviewed.Results Among the 27 crises of bronchopulmonary sequestration,22 were intralobar type,and 5 were extralobar type.All the patients with intralobar type had symptoms including cough,expectoration,fever,hemoptysis,but the 5 cases of extralobar type had no symptoms.Twenty cases were confirmed before operation by chest radiography,plain CT scan,enhanced CT scan,CT angiography,MR angiography,or selective arteriography.Chest operation was performed in all the cases,with successfully recovery after the operation,and no relapse Was found.Conclusions The clinical manifestations of bronchopulmonary sequestration are nonspecific.Selective arteriography,although invasive,plays a pivotal role in the diagnosis.Non-1invasive angiography including enhanced CT scan,CT angiography,and MR angiography have become important supplements to selective arteriography.Surgery is the optimal treatment,while the effect of interventional therapy needs further study.
