19例肺隔离症临床分析

Clinical analysis of pulmonary sequestration in 19 cases

目的肺隔离症(pulmonary sequestration)是一种先天发育异常性疾病,临床较少见。本文旨在总结该病特征,以降低误诊误治率。方法回顾性分析我院2009年1月至2010年12月手术病理活检确诊的19例肺隔离症患者临床资料。结果患者以咳嗽(n=10,52.63%)、咳痰(n=8,42.11%)为主要症状;病灶多位于左肺下叶(n=14,73.68%),胸部影像学检查以多发囊状影或软组织影多见(n=13,68.42%),增强CT扫描或血管造影可显示异常的体循环供血血管;手术证实17例为叶内型(89.47%),2例为叶外型(10.53%);组织病理学检查以肺组织发育不全及慢性炎症性改变为主;术后患者恢复较好。结论肺隔离症临床表现无特异性,影像学检查,尤其是增强CT和血管造影是主要的诊断手段,手术疗效可靠。

Objective Pulmonary sequestration was a rare congenital dysplasia lung disease. The primary purpose of this study was to summarize the clinical characteristics and reduce its misdiagnosis rate. Methods Clinical data of 19 cases of pulmonary sequestration, whose diagnosis was confirmed by surgical biopsy from January 2009 to December 2010 in our hospital, were ana- lyzed retrospectively. Results Cough and sputum were the most frequent symptom （ n = 10, 52.63% ; 8, 42.11% ）. Lesions usually located in the left lower lobe （ n = 14, 73.68% ） , charac- terized by muhiple cystic or soft tissue shadow oh chest imaging examination （ n = 13, 68.42% ）. Further scans with enhanced CT or angiography showed the abnormal blood vessels from the systemic circulation. According to the findings of surgery, 17 cased were intralobar pulmonary sequestration （ 89.47% ） , while the rest 2 were extralobar （ 10.53% ） , whose tissues were all detected hypopla- sia and chronic inflammatory by histopathological examinations. Fortunately, all patients recovered well after surgeries. Conclusion Because of the non-specific clinical manifestations of pulmonary sequestration, chest imaging examination, especially enhanced CT or angiography,was the essential for its diagnosis. Following surgery leads a desirable prognosis.