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机构地区:[1]中南大学湘雅医院心胸外科,湖南长沙410008 [2]江西省胸科医院,江西南昌330006
出 处:《中国现代医学杂志》2009年第5期641-643,649,共4页China Journal of Modern Medicine
摘 要:目的讨论肺炎性假瘤的诊断及治疗。方法回顾性总结我科1980年1月~2008年6月外科手术的306例肺炎性假瘤的诊断及外科治疗经验。结果肺炎性假瘤临床表现及辅助检查缺乏特异性,诊断靠病检确诊,易误诊为肺癌,应积极手术切除。本组术前确诊58例(18.9%),误诊为肺癌156例(50.9%);行肺叶切除262例(85.6%),局部切除42例(13.7%),左全肺切除及右全肺切除各1例;占同期肺部肿瘤手术的7.4%(306/4147),其中2004年前为5.8%(117/1973),2004年后为8.7%(189/2174);全组均痊愈出院,随访1个月~1年恢复良好。结论肺炎性假瘤发病率逐年上升,易误诊,确诊靠病检,外科手术切除预后良好。[Objective] To study the diagnosis and surgical treatment of pulmonary inflammatory pseudotumor (PIP). [Methods] From Jan. 1980 to Jun. 2008, 306 cases of PIP were operated on. [Results] PIP had no specialty in 'respect of clinical symptoms and imaging manifestations. The diagnosis of PIP was quite difficult and it was easily misdiagnosed as lung cancer, trans-skin puncture biopsy was an important preoperative diagnostic measure, the operative treatment should be used. 58 (18.9%) cases were correctly diagnosed before operation, 156 (50.9%) cases were misdiagnosed as lung cancer. Operations were carried out in all the cases with 262 (85.6%) lobectomies, 42 (13.7%) wedge-shaped resections, 1 case of left pneumonectomy and 1 case of right pneumonectomy. 306 cases were recovered smoothly and discharged in good condition. The result of postoperative follow-up was satisfactory. [Conclusions] The incidence of PIP is increased. PIP is always misdiagnosed as lung cancer. The proper kind of lung resection should be determined by preoperative or operative pathological biopsy diagnosis of lung lesions and excessive resection of normal lung tissues should be avoided. The prognosis of PIP is good.
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