【作者】 胡冬鑫；

【导师】 王洲；

【作者基本信息】 山东大学 ， 外科学， 2010， 硕士

【摘要】 目的：肺隔离症是一种较少见的先天性肺发育异常,目前临床上误诊率仍较高。本文对肺隔离症的发生与分型、临床诊断、治疗以及预后进行概括性的综述,探讨肺隔离症的诊疗方法,以期减少误诊率,提高外科治疗水平。方法：回顾性分析我院2003年8月～2009年8月手术治疗12例肺隔离症患者的临床资料。结果：2003年8月～2009年8月手术治疗肺隔离症12例,占我院同期行肺叶切除术治疗的所有肺良恶性病变的0.85％(12／1411)。本组病例男性4例,女性8例,平均年龄40岁。其中5例见异常血管进入病灶诊断为肺隔离症,其余误诊为肺囊肿合并感染、支气管扩张症、肺脓肿或肺癌。左侧8例,右侧4例,其中呈蜂窝状囊性改变的有6例,密度不均匀软组织密度块4例,密度均匀软组织密度块2例。全部为叶内型,均行病变肺叶切除术,有1例出现术中大出血,其余患者手术顺利,无术后并发症,无围手术期死亡。结论：肺隔离症是一种少见的先天性肺发育异常,术前误诊率较高,一些影像学特征和临床表现可提示肺隔离症的诊断,一旦确诊,应采取手术治疗。提高术前诊断率及肺下叶切除术中想到可能存在肺隔离症,是预防术中大出血的关键。手术治疗肺隔离症效果满意。更多还原

【Abstract】 Objective:Pulmonary sequestration is a rare congenital malformation of lung and its misdiagnosis rate is extremely high. It is of great significance to make a positive diagnosis before operation.Methods:14 patients of pulmonary sequestration from August 2003 to August 2009 were retrospectively studied. Their clinical data were analyzed.Result:Between August 2003 and August 2009,12 patients with pulmonary sequestration were operated.5 patients were diagnosed preoperatively which showed an abnormal feeding artery. Others were misdiagnosed as cyst of lung,bronchiectasis, lung cancer or pulmonary abscess. It was diagnosed as intralobar in all cases at surgery.8 patients had lesions in left lower lung and 4 patient in right lower lung.1 patient got massive hemorrhage in surgical operation Success of pulmonary lobectomy had been achieved in all cases without any death during the operation or postoperative complication.Conclusions:Pulmonary sequestration is a rare congenital malformation of lung and its misdiagnosis rate is extremely high. Some radiological features and clinical manifestations are sufficiently suggestive of diagnosis of pulmonary sequestration. Once the diagnosis is conformed, operation should be performed. The key to prevent massive hemorrhage in treatment is to improve preoperative diagnosis rate and pay attention to pulmonary sequestration when resect the lower lung. Surgical treatment can obtain excellent results.更多还原