肺隔离症26例诊断及外科治疗

目的：分析肺隔离症（PS）的临床特点、诊断及外科手术治疗经验。方法回顾性分析经手术治疗的26例PS的围手术期以及随访资料。结果26例PS患者术前诊断率为61．5％（16/26）；术前均行胸片和胸部CT平扫，其中增强CT薄层扫描＋血管CTA成像有8例，MRI5例；其中21例叶内型PS行肺叶切除术，5例叶外型行隔离肺切除术，术中均发现异常供血动脉，其中21例来源于胸主动脉、3例来源于腹腔干、2例来源于膈肌动脉。全部患者手术均顺利完成，无围手术期死亡病例，随访6个月症状均消失。结论胸部增强CT扫描及血管CTA成像和MRI有利于PS的术前诊断。手术是治疗PS安全且有效的方法，但术中应注意异常供血动脉的处理及预防术中以及术后大出血。

Diagnosis and surgical treatment of 26 cases with pulmonary sequestration

Objective To analyze the clinical characteristics,diagnosis and the surgical treatment experience of the pulmonary sequestration.Methods The clinical data from 26 patients with pulmonary sequestration undergoing surgical operation were reviewed and analyzed retrospectively.Results Pulmonary sequestration was diagnosed in 16 out of 26 patients before the operation with the diagnosis rate of 61.5%（16/26）.Pre-operation chest X-ray and plain CT-scan were performed in 26 cases.Enhancement CT scanning and CTA imaging were performed in 8 cases, magnetic resonance imaging were performed in 5 cases.21 patients with intralobar sequestration underwent lobectomy and 8 patients with extralobar sequestration underwent local lesion resection.Abnormal supply arteries were intraoprat-ibely found in 21 cases originating from the thoracic main artery,3 cases from the celiac artery,2 cases from the dia-phragm artery.Smooth recovery was achieved in all patients.No peri-operative death occurred.Symptoms disappeared were followed-up for 6 months.Conclusion Enhancement CT scanning,CTA imaging and magnetic resonance ima-ging （ MRI） may improve the diagnosis of pulmonary sequestration.Operation is a safe and effective method for the treatment of pulmonary sequestration.But intraoperative abnormal blood supply arteries should be paid attention to the treatment and prevention of intraoperative and postoperative bleeding.