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1、肺隔離癥的診斷及外科治療初向陽,張連斌,薛志強,張競(中國人民解放軍總醫(yī)院胸外科,北京100853)摘要:目的總結(jié)肺隔離癥(pulmonarysequesmnion,PS)的臨床特點、診斷及外科治療經(jīng)驗。方法回顧性分析1990-2007年我院胸外科經(jīng)手術(shù)治療69例PS的臨床病理資料。結(jié)果本紐.PS的術(shù)前診斷率為65.2%(45/69);術(shù)前行胸片和肺CT平掃41例,診斷率為53.7%(22/41);術(shù)前行增強CT薄層掃描28例,診斷率為82.1%(23/28)。61例葉內(nèi)型PS行肺葉切除術(shù),8例葉外型行隔離肺局部切除術(shù)。
2、術(shù)中發(fā)現(xiàn)異常供血動脈55例,來源于胸主動脈,8例來源于腹腔干,5例來源于膈肌動脈,1例來源于肋間動脈。全部患者手術(shù)順利,無圍手術(shù)期死亡。結(jié)論PS的謀診率較高,胸部増強CT薄層掃描冇利于PS的診斷。手術(shù)是治療PS安全、冇效的方法。關(guān)鍵詞:肺隔離癥;診斷;手術(shù)中圖法分類號:文獻標(biāo)識碼:AThediagnosisandsurgicaltreatmentofpulmonarysequestrationCHUXiang-yang,ZHANGLian-bin,XUEZhi-qiang,ZHANGJing(Departmentofth
3、oracicSurgery,thePLAGeneralHospital,Beijing100853,China)Abstract:ObjectiveTosummarizetheexperiencesofthediagnosisandsurgicaltreatmentofpulmonarysequestration.MethodsTheclinicaldataof69patientswithpulmonarysequestrationunderwentoperationfrom1990to2007inPLAgeneralh
4、ospitalwererctrospccitvclyreviewed?ResultsOf69patients,45werediagnosedpulmonarysequestrationbeforeoperation,andthediagnosisrateswas65?2%(45/69).Pre-operationchestX-rayandplainCT-scanwereperformedin41cases,22cases(53.7%)werecorrectlydiagnosed?Contrastenhancedspira
5、lCTscanwereperformedin28patients,23(85.5%)werecorrectlydiagnosed?Sixty-onepatientswithintralobarsequestratrationunderwentlobectomy,and8patientswithextralobarsequestrationunderwentlocallesionresection.Theabnormalsupplyarteryswereoriginatedfromthoracicmainarteryin5
6、5cases,celiaccirteryin8cases,diaphragmarteryin5cases,interlobearteryin1case?Allpatientsrecoveredsmoothly.NooperativedeathoccuiTed.ConclUsi0nPulmonarysequestrationisararedisease,andpartofpatientsareaftenmis-diagnosed.ContrastenhancedspiralCTscanmayimprovethediagno
7、sisofpulmonarysequestration.Operationisasafeandeffectivemethodtotreatpulmonarysequestration.Keywords:pulmonarysequestration;diagnosis;operation作者簡介:初向陽,男,山東省萊蕪市人,碩匕副教授,發(fā)表論文io余篇,主要從事肺癌■儉管癌■胸部創(chuàng)傷的基礎(chǔ)與臨床方面的研究。電話:(010)66939632,E-mail:xuezhiq2001ahoo.com.cn收稿日期:20081021
8、:修回日期:200812-11肺隔離癥(pulmonarysequestration,PS)是一種較少見的先天性肺發(fā)育異常,其特征是部分胚胎肺紐?織與正常支氣管不交通,并與正常肺組織隔開,其血液供應(yīng)來自體循環(huán)的異常分支,臨床上常被誤診為支氣管擴張、肺囊腫和肺癌⑴。1990-2007年我科經(jīng)手術(shù)治療PS69例,現(xiàn)總結(jié)報