33例肺隔离症的临床诊治经验

目的探讨并总结肺隔离症的有效外科诊治方法,从而更好地提高肺隔离症的确诊率、减少和避免误诊误治。方法回顾分析33例肺隔离症的临床诊断和治疗。结果 1989年1月-2010年12月结合温岭市中医院(10例)和上海市胸科医院(23例)共收治的33例肺隔离症患者的临床资料,其中叶内型26例,均行病变肺叶切除术;叶外型7例,行肺局部隔离病变切除。术前明确诊断25例,误诊6例,手术死亡1例,余无术后并发症发生。随访6个月～15年,3例失访,其余29例无复发,均健在。结论肺隔离症诊断方法主要为多排螺旋CT,其增强扫描及三维重建可显示异常供血动脉,是诊断肺隔离症的首选检查方法。外科手术治疗是本症最佳治疗方法,术中注意异常动脉的妥善处理。

Clinical Diagnosis and Treatment of 33 Patients with Pulmonary Sequestration

Objective To investigate and summarize the effective surgical treatment methods of the pulmonary sequestration in order to improve the diagnosis of pulmonary sequestration,reduce and avoid the misdiagnosis.Methods The data of diagnosis and treatment of 33 cases of pulmonary sequestration were analyzed retrospectively.Results Ten cases were from our hospital and 23 cases from Shanghai Chest Hospital.26 cases with intralobar pulmonary sequestration underwent the pulmonary lobectomy;7 cases with extralobar pulmonary sequestration underwent the local segment resection.Before the operatioin,25 cases were correct diagnosed and 6 cases misdiagnosed.1 case died from operation.There was no complication in other cases.Six to fifteen months follow up showed 29 cases were without reoccurrence,and 3 cases lost to follow up.Conclusion The multi-slice spiral CT is the main diagnosis methods for pulmonary sequestration.The enhanced scanning and three-dimensional reconstruction can show the abnormal feeding artery,and is the first choice for the diagnosis of pulmonary sequestration.Surgical treatment is the best treatment for this disease.The proper handling of abnormal arteries should be paid more attention in operation.