肺隔离症20例临床诊治分析

The diagnosis and surgical treatment of pulmonary sequestration

目的：总结肺隔离症的诊断和外科治疗体会.方法：回顾性分析2004年1月至2014年1月,我科收治20例肺隔离症患者的临床资料并复习相关文献.结果：本组20例中9例术前误诊,误诊率45％.本组无围手术期死亡,术中大出血2例,术后并发肺不张、肺部感染1例,术后并发咯血1例.所有患者均痊愈出院.随访2个月～8年,失访2例,其余18例术后均生存良好,无复发.结论：肺隔离症是一种少见的先天性肺发育畸形,缺乏特异性症状、体征及影像学特征,术前误诊率较高,容易发生反复的肺部感染、咯血,手术是治疗肺隔离症较为有效的方法,而手术成功的关键是处理好异常营养血管.

Objective：To summarize the experience of the diagnosis and surgical treatment of 20 cases of pulmonary sequestration. Methods： The clinical data from 20 patients with pulmonary sequestration undergoing surgical operation in our hospital from Jan 2004 to Jan 2014 were retrospectively reviewed. Results： In this group of 20 patients, pulmonary sequestration was diagnosed only in 9 cases （45%） preoperatively. There was no operative death, Two patients got massive hemorrhage in the operation, one patient got atelectasis and pulmonary infection post the operative proceure, and another one got massive hemoptysis post the operation. All patients recovered. Fellow-up was performed in 18 patients, and no long-term complication was found. Conclusion： Pulmonary sequestration is a rare congenital pulmonary malformation. The misdiagnosis rate of pulmonary sequestration is high because of its non-specific symptoms. Operation is a safe and effective method to treat pulmonary sequestration, but identifying and management of the aberrant artery is key to the procedure.