孤立性肺结节的诊治分析

目的总结孤立性肺结节(SPN)的诊断和治疗体会。方法回顾性分析我院2010年1月~2014年5月手术治疗的120例SPN患者的临床资料。结果术后病理检查提示良性病变30例,包括结核瘤10例,错构瘤8例,炎性假瘤6例,硬化性血管瘤2例,肺囊肿2例,霉菌球1例,淋巴结1例;恶性病变90例,包括腺癌56例,鳞癌26例,腺鳞癌3例,小细胞癌1例,大细胞癌1例,转移癌3例。SPN良、恶性患者年龄、临床症状、吸烟指数、结节直径、毛刺分叶症、结节边界、胸膜牵拉、胸膜皱缩比较差异有统计学意义(P0.05)。结论患者年龄、临床症状、吸烟指数、结节直径、毛刺分叶症、结节边界模糊、胸膜牵拉、胸膜皱缩对判断SPN的良恶性有重要意义;对于可疑恶性病变者,应积极手术治疗。

Diagnosis and surgical treatment of solitary pulmonary nodules

Objective To investigate the diagnosis and treatment of the solitary pulmonary nod-ules(SPN). Methods From January 2010 to May 2014,the clinical and pathological data of 120 pa-tients of SPN were retrospectively analyzed. Results Benign lesions were diagnosed by postoperative pa-thology in 30 cases,including 10 cases of tuberculoma,8 cases of hamartoma,6 cases of inflammatory pseudotumor,2 cases of sclerosing hemangioma,2 case of pulmonary cyst,1 case of fungal ball,and 1 case of lymph node;malignant lesions were diagnosed postoperatively in 90 cases,including 56 cases of adeno-carcinoma,26 cases of squamous cell carcinomas,3 cases of adenosquamous carcinoma,1 case of small cell carcinoma,1 case of large cell cancer,and 3 cases of metastatic lung cancer. There were significant differences in age,clinical symptoms,smoking history,nodule diameter,speculation and lobulation,nodule boundary,pleural retraction,and pleural shrinkage of the patients(P < 0. 05). Conclusion Age,nodule diameter,speculation and lobulation,nodule boundary,pleural retraction,and pleural shrinkage are the predictors of malignancy in patients with SPN. For suspected malignant lesions,surgical treatment should be taken.