肺隔离症的诊断和治疗

Diagnosis and treatment of pulmonary sequestration

目的对肺隔离症的病因、分类、发病率，诊断及治疗加以探讨。方法回顾分析４２例肺隔离症的临床资料及文献复习。结果自１９６４～１９９７年间通过手术切除并经病理证实的４２例肺隔离症。发病率占同期手术的０３２％，其中叶内型３７例（８８％），叶外型５例（１２％）。叶内型２２例合并感染症状，９例合并咯血症状。叶外型１例合并感染症状，１例合并咯血症状，该病例隔离肺与食管相通。术前确诊或拟诊２９例（６９％）。结论肺隔离症诊断方法主要为Ｘ线检查，支气管碘油造影，选择性动脉造影及ＣＴ检查。术中应避免损伤隔离肺的营养血管，对叶外型肺隔离症应注意其它脏器的畸形。

Objective To explore the cause, classification, incidence, diagnosis and treatment of pulmonary sequestration. Method 42 cases analysed and literatures reviewed. Result 42 cases of sequestration were presents which were resected and confirmed by pathology in our department from 1964 to 1997. 29 cases (69%) were confirmed before operation. The incidence rate was 0.32% comparing with the sametime operations. There were 37 cases (88%) of intralobar type, and 5 cases (12%) of extralobar type. 22 cases accompanied with infection, 9 cases with hemoptysis in intralobar type. 1 case with infection and 1 case with hemoptysis in extralobar type, in the latter case, there was a fistula between the affected lung and the esophagus. Conclusion Pulmonary sequestration is not a rare illness. The diagnosis mainly depends on X ray. Sometimes, bronchography, retrograde arteriography or CT can also make the diagnosis correctly. Special attention should be paid to avoiding injure to the vessels which supply the isolated lung during operation.