肺隔离症30例临床分析
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上海市医学重点发展基金


Pulmonary sequestration: a clinical analysis of 30 cases
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    【摘要】目的 研究肺隔离症的临床特点及治疗方法。方法 回顾性分析2006年1月至2012年2月同济大学附属上海市肺科医院收治的30例经手术病理证实的肺隔离症患者的临床资料并复习相关文献。结果 30例患者中,男19例,女11例,年龄18~63岁,平均35岁。病程2周至33年。主要临床症状为反复咳嗽、咳痰、低热、咯血、胸闷、胸痛。5例无症状。30例患者中叶内型25例,叶外型5例,叶内型常有咳嗽、咳痰、低热、咯血等症状,叶外型多无症状。术前确诊20例,主要诊断方法为X线胸片、胸部CT平扫及增强扫描、CT血管造影(CTA)。所有患者均行手术治疗,术后恢复良好,随访无复发。结论 肺隔离症的临床表现缺乏特异性,选择性主动脉造影是诊断该病的金标准,但为有创检查。CT增强、CTA、螺旋CT增强等非侵袭性血管成像技术已成为诊断肺隔离症的重要补充手段。手术是肺隔离症的最佳治疗方案,介入栓塞治疗的疗效尚待研究。

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    【Abstract】Objective To Investigate the clinical manifestations, diagnosis and treatment of pulmonary sequestration. Methods 30 patients with pulmonary sequestration confirmed by histopathological studies were analyzed and related literatures were reviewed. Results Among these patients, 25 were intralobar type and 5 were extralobar type. All patients with intralobar type had symptoms of cough, expectoration, fever and hemoptysis while 5 patients with extralobar type were asymptomatic. 20 patients were diagnosed preoperatively by chest radiography, plain CT scan, enhanced CT scan or CT angiography. Operation was performed in all the patients, with successfully recovery after operation, and no relapse was found. Conclusions The clinical manifestations of pulmonary sequestration are nonspecific. Although invasive, Selective arteriography was gold standard for pulmonary sequestration. Noninvasive angiography including enhanced CT scan, CT angiography have become important supplements to selective arteriography. Surgery is the optimal treatment, while the effectiveness of interventional therapy needs further investigations.

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  • 收稿日期:2012-07-19
  • 最后修改日期:2012-11-06
  • 录用日期:2012-11-26
  • 在线发布日期: 2013-02-22
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