肺隔离症并扭转四例临床分析

Clinical analysis of pulmonary sequestration with torsion in 4 cases and literature review

目的总结分析儿童肺隔离症并扭转的临床特点。方法回顾性分析2010年11月至2020年11月深圳市儿童医院收治的4例肺隔离症并扭转患儿的临床表现、辅助检查(胸腔B超、胸部增强CT、病理结果)、治疗及转归情况。结果4例患儿中,男女各2例,年龄分别为3岁8个月、6岁9个月、7岁5个月、10岁。4例患儿均为叶外型,左侧2例,右侧2例,均以腹痛为首发症状,后伴有胸痛2例,发热2例,气促喘息1例;4例行胸腔彩超均显示胸腔内软组织团块影,其中2例中量胸腔积液,2例少量胸腔积液,4例行胸部增强CT均显示不强化或轻度强化的软组织团块影,供血动脉显示不清;病理结果均显示肺隔离症并出血坏死;4例均行胸腔镜手术,病情好转出院。结论儿童肺隔离症并扭转常以腹痛为首发或主要症状,伴或不伴胸痛,胸腔超声和CT见胸腔内软组织密度团块影,增强时团块不强化或轻度强化,供血动脉显示不清,手术治疗效果好。

Objective To summarize and analyze the clinical characteristics of children pulmonary sequestration with torsion.Methods The main clinical manifestations,auxiliary examinations(chest B ultrasound,chest enhanced CT,pathological results),treatment and prognosis of 4 cases with pulmonary sequestration with torsion in Shenzhen Children′s Hospital from November 2010 to November 2020 were retrospectively analyzed.Results Among the 4 children,2 were male and female,The age was 3 years and 8 months,6 years and 9 months,7 years and 5 months,10 years old respectively.All the 4 cases were extralobar sequestrations,2 cases were on the left side and 2 cases were on the right side.Abdominal pain was the first symptom,followed by chest pain in 2 cases,fever in 2 cases,shortness of breath in 1 case;4 cases of chest color ultrasonography showed the soft tissue masses in the chest,medium volume pleural effusion in 2 cases,small pleural effusion in 2 cases,enhanced chest CT showed soft tissue mass without enhancement or slight enhancement in all 4 cases,and the blood supply artery was not clearly shown.Pathological results showed pulmonary sequestration with hemorrhage and necrosis,and 4 cases were cured after thoracoscopic surgery.Conclusions Abdominal pain is often the first or main symptom of pulmonary sequestration with torsion in children,accompanied by or without chest pain.Chest ultrasound and CT can reveal the soft tissue density mass which is not enhanced or slightly enhanced during enhancement,and the blood supply artery is unclear.The effect of resection is well.