先天性大叶性肺气肿的诊断和治疗  

Diagnosis and Treatment of Congenital Lobar Emphysema

作　　者：范茂槐[1] 曾骐[1] 张娜[1] 陈诚豪[1] 

机构地区：[1]首都儿科研究所,北京市100020

出　　处：《中国全科医学》2008年第14期1262-1263,共2页Chinese General Practice

摘　　要：目的探讨先天性大叶性肺气肿的病因和诊治方法。方法回顾我院1983—2006年共收治的25例先天性大叶性肺气肿患儿的临床资料,总结其临床表现、X线特点、病变累及的肺叶、手术情况、病理表现。结果25例均手术治疗,无术中死亡。其中1例因合并先天性心脏病,术后2d家长放弃治疗。病变位于左上叶12例,右上叶8例,右中叶5例。12例行急诊手术患儿术后恢复良好。随访半年至13年均症状消失、无并发症及生长发育障碍,胸部X线片显示余肺膨胀良好,治疗效果满意。结论婴幼儿期,有大叶性肺气肿症状且有加重趋势的患儿,一旦确诊须急诊或尽快手术治疗;无明显症状者,X线或CT检查如有严重的纵隔肺疝,压迫正常肺组织者也应手术治疗。提高对该病的认识可降低病死率,早诊断,早治疗效果满意。Objective Approach into the etiopathogenisis, morbidity, diagnosis and treatment of congenital lobar emphysema. Methods Retrospective research of 25 cases of congenital lobar emphysema patients enrolled in our department from 1983 to 2006. Age of onset, clinical manifestation, X -ray characteristics, pulmonary lobes involved, surgery circumstance and pathology results were taken into account. Results All the 25 patients were performed surgery. No death occurred interoperation. One patient was accompanied by congenital cardiopathy, and his parents gave up treatment two days after operation. Positions of the lesions were as follows ： 12 cases left upper lobe, 8 cases right upper lobe, 5 cases right central lobe. Of the 25 cases, 12 cases had emergency operation, and recovered well. All were followed up half a year to 13 years, with symptom disappeared. No complications and developmental disorders occurred. Chest X - ray displayed that the remnant lung distended well, and the therapeutic efficacy was satisfactory. Conclusion If the symptoms had an aggravate tendency, the child should be performed operation as soon as possible, especially during infancy. If X - ray or CT hints showed severe mediastinal pulmonary hernia with oppression to the normal lung tissues surrounding, the patients should also be operated. Knowing the disease very well, we could decrease the mortality rate. Earlier be diagnosed and treated, better the satisfactory effect.

关 键 词：肺气肿 先天性 诊断 治疗 

分 类 号：R725.633[医药卫生—儿科]