CAJ | 학술논문

目的：分析肺隔离症（ PS）的临床特点、诊断及外科手术治疗经验。方法回顾性分析经手术治疗的26例PS的围手术期以及随访资料。结果26例PS患者术前诊断率为61．5％（16/26）；术前均行胸片和胸部CT平扫，其中增强CT薄层扫描＋血管CTA成像有8例，MRI 5例；其中21例叶内型PS行肺叶切除术，5例叶外型行隔离肺切除术，术中均发现异常供血动脉，其中21例来源于胸主动脉、3例来源于腹腔干、2例来源于膈肌动脉。全部患者手术均顺利完成，无围手术期死亡病例，随访6个月症状均消失。结论胸部增强CT扫描及血管CTA成像和MRI有利于PS的术前诊断。手术是治疗PS安全且有效的方法，但术中应注意异常供血动脉的处理及预防术中以及术后大出血。
목적：분석폐격리증（ PS）적림상특점、진단급외과수술치료경험。방법회고성분석경수술치료적26례PS적위수술기이급수방자료。결과26례PS환자술전진단솔위61．5％（16/26）；술전균행흉편화흉부CT평소，기중증강CT박층소묘＋혈관CTA성상유8례，MRI 5례；기중21례협내형PS행폐협절제술，5례협외형행격리폐절제술，술중균발현이상공혈동맥，기중21례래원우흉주동맥、3례래원우복강간、2례래원우격기동맥。전부환자수술균순리완성，무위수술기사망병례，수방6개월증상균소실。결론흉부증강CT소묘급혈관CTA성상화MRI유리우PS적술전진단。수술시치료PS안전차유효적방법，단술중응주의이상공혈동맥적처리급예방술중이급술후대출혈。
Objective To analyze the clinical characteristics,diagnosis and the surgical treatment experience of the pulmonary sequestration.Methods The clinical data from 26 patients with pulmonary sequestration undergoing surgical operation were reviewed and analyzed retrospectively.Results Pulmonary sequestration was diagnosed in 16 out of 26 patients before the operation with the diagnosis rate of 61.5%(16/26).Pre-operation chest X-ray and plain CT-scan were performed in 26 cases.Enhancement CT scanning and CTA imaging were performed in 8 cases, magnetic resonance imaging were performed in 5 cases.21 patients with intralobar sequestration underwent lobectomy and 8 patients with extralobar sequestration underwent local lesion resection.Abnormal supply arteries were intraoprat-ibely found in 21 cases originating from the thoracic main artery,3 cases from the celiac artery,2 cases from the dia-phragm artery.Smooth recovery was achieved in all patients.No peri-operative death occurred.Symptoms disappeared were followed-up for 6 months.Conclusion Enhancement CT scanning,CTA imaging and magnetic resonance ima-ging ( MRI) may improve the diagnosis of pulmonary sequestration.Operation is a safe and effective method for the treatment of pulmonary sequestration.But intraoperative abnormal blood supply arteries should be paid attention to the treatment and prevention of intraoperative and postoperative bleeding.