CAJ | 학술논문

目的：探讨新生儿先天性肺囊性病变的临床特征。方法回顾性分析2008年1月至2014年6月广州市妇女儿童医疗中心新生儿科收治的28例经影像学检查或病理检查确诊先天性肺囊性病变病例的一般情况、临床表现、影像学检查、诊断、治疗及预后等,并复习相关文献。结果28例先天性肺囊性病变病例中,男20例,女8例,包括大叶性肺气肿16例(57.14%),肺隔离症7例(25.00%),先天性囊性腺瘤样畸形4例(14.29%),支气管源性囊肿1例(3.75%)；主要症状为气促(78.57%)、发绀(39.29%)、咳嗽喘息(17.86%)、喂养困难(14.29%)、发热(10.71%),无症状患儿占21.43%；2例合并先天性心脏病,4例合并其他畸形(如膈疝、喉软骨发育不良、漏斗胸、多囊肾)；胸部CT 均提示有病变；4例行肺叶切除术,其中2例为急诊手术,其余保守治疗；好转出院17例,自动出院8例,死亡3例。结论新生儿期发现先天性肺囊性病变最常见类型是大叶性肺气肿。临床主要表现为气促、发绀。对于可疑病例,应尽早行胸部 CT 或 MRI 检查等,同时行心脏彩超、超声检查排除有无合并其他先天畸形。治疗效果好,需长期随访。
목적：탐토신생인선천성폐낭성병변적림상특정。방법회고성분석2008년1월지2014년6월엄주시부녀인동의료중심신생인과수치적28례경영상학검사혹병리검사학진선천성폐낭성병변병례적일반정황、림상표현、영상학검사、진단、치료급예후등,병복습상관문헌。결과28례선천성폐낭성병변병례중,남20례,녀8례,포괄대협성폐기종16례(57.14%),폐격리증7례(25.00%),선천성낭성선류양기형4례(14.29%),지기관원성낭종1례(3.75%)；주요증상위기촉(78.57%)、발감(39.29%)、해수천식(17.86%)、위양곤난(14.29%)、발열(10.71%),무증상환인점21.43%；2례합병선천성심장병,4례합병기타기형(여격산、후연골발육불량、루두흉、다낭신)；흉부CT 균제시유병변；4례행폐협절제술,기중2례위급진수술,기여보수치료；호전출원17례,자동출원8례,사망3례。결론신생인기발현선천성폐낭성병변최상견류형시대협성폐기종。림상주요표현위기촉、발감。대우가의병례,응진조행흉부 CT 혹 MRI 검사등,동시행심장채초、초성검사배제유무합병기타선천기형。치료효과호,수장기수방。
Objective To explore the clinical characteristics of neonatal congenital cystic lung lesions. Methods Between January 2008 and June 2014,total 28 cases diagnosed congenital cystic lung lesions in neonatal center of Guangzhou Women and Children's Hospital were collected.The clinical data were analyzed including manifestations,lesion characteristics,imaging,diagnosis,treatment and prognosis,and the related literature were reviewed.Results There were 20 male and 8 female,16 cases of lobar emphysema,7 cases of pulmonary seques-tration,4 cases of congenital cystic adenomatoid malformation and 1 case of bronchogenic cyst.Main symptoms were dyspnea(78.57%),cyanosis (39.29%),wheezing cough (17.86%),feeding difficulties (14.29%),fever (10.71%),asymptomatic(21.43%).Two cases combined with congenital heart disease,4 cases combined with other malformations(such as diaphragmatic hernia,laryngeal stridor,funnel chest,polycystic kidney).There were lesions in chest CT image,4 cases underwent lobectomy,other cases underwent conservative treatment.Seventeen cases got better and discharge,3 cases dead.Conclusion The most common type of congenital cystic lung lesions in neonate is lobar emphysema.Main manifestations are dyspnea,cyanosis.If we suspect congenital cyst-ic lung lesions,we should do chest CT or MRI scan soon ,also do echocardiography and ultrasound to exclude other malformations.The treatment effect is satisfactory,and the outcome need long time to follow up.