19例先天性支气管囊肿临床分析

Clinical Analysis of 19 Patients with Congenital Bronchogenic Cyst

目的:探讨先天性支气管囊肿的临床、影像学特点及治疗方法。方法:对19例经手术和病理活检证实的先天性支气管囊肿患者的临床资料进行了回顾性分析。结果:本组19例患者中,肺内囊肿15例(79%),纵隔囊肿4例。临床症状表现为咳嗽14例(74%),咯血7例,呼吸困难5例,胸痛5例;其中13例患者(68%)出现并发症,包括感染、大咯血、气胸和胸膜炎等。影像学表现为单发边界清楚的软组织或水样密度包块影4例,单发薄壁含气囊腔4例,单发圆形含气液平的包块影7例,多发环形透光影4例。所有患者均进行了开胸囊肿切除术。结论:先天性支气管囊肿多位于肺内,常见临床症状为咳嗽,影像学以单发含气液平的包块影为多见,手术切除是最好的治疗方法。

To investigate clinical manifestation, imageologic feature and treatment of congenital bron-chogenic cyst. Methods： A retrospective analysis was conducted in 19 patients with congenital bronchogenic cyst who were diagnosed by pathologic examination. Results： There were 15 intrapulmonary and 4 mediastinal bronchogenic cysts. Fourteen patients （74%） presented with cough, 7 with hemoptysis, 5 with dyspnea and 5 with chest pain. Thirteen patients （68%） presented with complications： infection, severe hemoptysis, pneumothorax and pleuritis.The imaging of bronchogenic cysts included solitary sharply marginated soft--tissue or water density masses （4 patients）, isolated rounded thin walled air--filled cyst （4 patients）, isolated rounded mass with an air--fluid level （7 patients）, and multiple circular translucency cysts （4 patients）. In 19 patients, surgical excision of the cyst was performed by thoracotomy. Conclusion： Congenital bronchogenic cysts are usually intrapulmonary. Cough is the most common symptom. The most common imaging manifestation is isolated rounded mass with an air--fluid level. The surgical resection is the best treatment.