先天性支气管囊肿临床分析

目的探讨先天性支气管囊肿的临床特点，为临床诊断和治疗提供参考。方法回顾性分析我院2001年2月—2007年8月经手术切除病理证实的119例先天性支气管囊肿患者的临床资料。结果根据X胸片、胸部CT检查结果，本组患者病灶肺内型109例、纵隔型10例，其中气囊肿45例、液囊肿55例、多发肺囊肿9例。肺内型多以并发感染就诊，其中58例表现为咳嗽、咳痰，22例伴发热，47例表现为咯血、痰血或痰中带血，8例有不同程度的胸痛；CT特征为囊腔大、周围软组织少的“块中囊”，或薄壁的空腔、多发性蜂窝状、囊腔状环形透光影。纵隔型7例于体检时偶然发现，2例为反复咳嗽、咳痰，1例为胸闷乏力；CT特点为边界清楚、密度一致的孤立性圆形或卵圆形占位阴影，与周围器官组织相互挤压变形。结论先天性支气管囊肿以肺内型为多，临床表现无特异性，主要为咳嗽、咳痰及咯血，CT检查以块中囊为其特征性表现。手术切除是治疗的最佳方案。

Clinical analysis of congenital bronchial cyst

Objective To study the clinic features of congenital bronchial cyst. Methods Clinical data of 119 patients with congenital bronchial cysts confirmed by pathology after operation from Feb. 2001 to Aug. 2007 were reviewed retrospectively. Results There were 109 patients with intrapulmonary bronchogenic cysts and 10 patients with mediastinal bronchogenic cysts showed by X-ray and CT. Of the 109 patients, 45 were air cysts, 55 were liquid cysts and 9 were multiple pulmonary cysts. Intrapulmonary congenital bronchial cysts were diagnosed with few exceptions due to infections. Fifty-eight of 109 patients （53%） presented with cough and sputum production, 22 cases accompanied by fever, 47 presented with hemoptysis or blood-stained sputum. 8 with chest pain. The CT imaging features were ＂bag included mass＂, which was characterized by a big bag surrounded by a little soft-tissue, or thin walled cavity, or multiple honeYComb or cystoid circular translucency. Seven of 10 patients With mediastinal bronchogenic cysts incidentally discovered on a radiograph obtained for other reasons were almost asymptomatic. Two cases presented with cough, sputum production due to compression of trachea, 1 with dyspnea due to compression of oesophagus. The CT imaging features included isolated well-defined round shape or ovoid soft-tissue mass with isodensity, and mutual compression between the surrounding organs. Conclusion The main type of congenital bronchial cysts is intrapulmonary bronchogenic cysts. The clinical manifestations are cough, sputum production and hemoptysis, and the imaging feature is ＂bag included mass＂ on CT scan. The optimal treatment is surgical resection.