肺隔离症的临床诊断与治疗

Clinical Diagnosis and Therapy of Pulmonary Sequestration

目的分析总结肺隔离症(PS)的临床诊断及治疗方法。方法回顾分析2000年2月2009年10月确诊的27例PS患者临床特征、诊断方法及治疗手段。结果 27例PS患者均经影像学和手术确诊,其中叶内型22例,叶外型5例,行左下肺切除17例,右下肺切除10例;全部手术切除。术后并发胸腔积液1例,肺不张2例,分别给予穿刺抽液、纤维支气管镜吸痰等积极治疗后痊愈,其余患者恢复较好,随访6～60个月无复发。结论 PS手术前误诊率高,诊断方法主要为X线平片、CT及CT增强血管照影(CTA)检查。CTA可显示异常供血动脉,是诊断PS的首选检查方法。一经明确诊断应尽早给予治疗,治疗方案主要包括手术和螺圈栓塞。

Objective To summary the diagnosis and therapy of pulmonary sequestration.Methods Clinical symptoms,methods of diagnosis and treatments of 27patients diagnosed with pulmonary sequestration from February 2002to October 2009were analyzed retrospectively.Results Twenty-seven patients were all confirmed by imaging and surgery,and had undergone surgical excision.Twenty-two patients were with intralober pulmonary sequestrateon （IPS）and five were with extralober pulmonary sepuestration（EPS）;17patients were treated by left lower lobectomy,and 10patients required right lower lobectomy.After the surgery,there were one patient with pleural effusion and two patients with atelectasis who suffered from complications postoperatively,and they were healed by symptomatic treatment.The rest recovered well.There were no recurrence from six to 60months follow-up.Conclusion Pulmonary sequestration may be misdiagnosed easily.The main methods for the examination include X-ray,CT and CTA. CTA can detect anomalous systemic artery,which should be the first choice in diagnosing of pulmonary sequestration. Surgery and coil embolization are the main treatments.Once being confirmed,pulmonary sequestration should be treated as soon as possible.