肺隔离症患者的临床诊疗

Research of Diagnosis and Treatment in Pulmonary Sequestration

目的:分析肺隔离症患者的临床表现和CT影像学特点,为肺隔离症的诊断提供参考。方法:通过Pacas影像系统和电子病历管理系统收集2011～2016年间于我院就诊的肺隔离症患者病历和影像学资料,采用SPSS 19.0软件统计分析,总结肺隔离症患者的临床表现和CT影像学特征。结果:共计19例肺隔离症患者,男性14例,女性5例,平均发病年龄为(43.4±20.4)岁。临床症状以咳嗽、咳痰或咯血为主,89.5%的病灶位于左肺。CT上病灶密度以实性、囊实性为主,形状以团状和片状为主。病灶平均直径为(4.0±2.8)cm。供血动脉主要来源于降主动脉和胸主动脉,CT上呈蝌蚪状、点状或线条状表现。组织病理检查提示病灶呈分化成熟的肺组织、炎性细胞浸润和结缔组织增生等改变。结论:肺隔离症患者缺乏特异性临床表现,CT上病灶供血动脉复杂多变。对于反复咳嗽、咳痰或咯血的患者,应完善增强CT检查,避免肺隔离症的漏诊及误诊。

Objective:To determinate the clinical presentations and chest computer tomography(CT)features of pulmonary sequestration,which may be crucial to pulmonary sequestration diagnosis.Methods:All data of pulmonary sequestration patients were collected from Pacas and electronic medical management system between 2011 and 2016 in our hospital.Then it was to explore the clinical presentations and CT features by SPSS 19.0 statistics software.Results:A total of 19 pulmonary sequestration patients(14 males and 5 females)were selected.The average age was 43.4±20.4.The most common complaints were cough,sputum and hemoptysis.Moreover,the ratio of left lobe was 89.5%.The density of lesions were mainly solid and cysts,while the shape showed cluster and patchy in the chest CT scan.The average diameter of lesion was4.0±2.8 cm.In addition,the arterial supply was mainly from the descending aorta and thoracic aorta.The distribution of artery was turned to todpole,dot or line shape.Histopathological assays demonstrated as welldifferentiated lung tissue,infiltration of inflammatory cells and proliferation of connective tissue.Conclusion:Pulmonary sequestration is lack of specific manifestations,and the arterial supply is also complicated in the chest CT scan.Therefore,contrast enhanced CT should be considered for those suspicious patients with recurrent cough or sputum.