成人肺内型支气管肺囊肿的诊断及外科治疗  

Diagnosis and surgical treatment intropulmonary bronchogenic cyst

作　　者：兰峻斌[1] 段明科[1] 高毅哲[1] 高木火[1] 吴艺根[1] 

机构地区：[1]福建省厦门市第二医院胸外科,362001

出　　处：《齐齐哈尔医学院学报》2012年第24期3358-3360,共3页Journal of Qiqihar Medical University

摘　　要：目的提高对成人肺内型支气管肺囊肿的正确诊断率及手术治疗水平。方法回顾性分析我科从2001年3月～2012年3月手术治疗49例成人肺内型支气管肺囊肿的临床资料,男18例,女31例,年龄18～62岁,平均(41.6±14.3)岁。45例(91.84%)有反复咳嗽、咳痰,胸痛、胸闷25例(51.02%),发热14例(28.57%),痰中带血17例,咯血6例。入院前被误诊误治24例,临床误诊率达到48.98%。根据病史、临床表现、胸部CT及痰液涂片检查等进行鉴别诊断,术前误诊率降至18.37%。结果 49例采取手术治疗50例次,其中1例首次行左肺下叶切除术,半年后行右肺中叶切除术,所有病例均经病理学诊断证实,其中2例为肺隔离症,4例合并肺曲菌球病。本组无手术死亡,均痊愈出院。结论外科手术是该病首选疗法,早期手术可以明显减少手术难度和并发症,电视胸腔镜手术可以选择性应用。Objective To improve the levels of diagnosis,differential diagnosis and surgical treatment of the intrapulmonary bronchogenic cyst.Methods From March,2001 to March,2001,49 patients were diagnosed and treated surgically for intrapulmonary bronchogenic cyst in the adult.There were 18 males and 31 females ranging in ages from 18 to 62 years.Majority of the cases suffered from recurrent cough and sputum（91.84%）.The rate of miss diagnosis was 48.98% before administration.Through careful analysis of case history,clinical manifestations and chest radiograph or computerized tomography（CT） the rate of miss diagnosis was decreased to 18.37% preoperatively.Results There was no mortality in this series.The diagnosis was confirmed by pathologist.49 patients underwent 50 operations.There were 4 patients complicated pulmonary aspergillosis.And 2 cases were confirmed pulmonary sequestration.Conclusions Surgical Treatment is the first choose for intrapulmonary bronchogenic cyst in the adult.Early surgical intervention may be avoided to severe complications and difficulty of the operation.VATS can be applied for some cases selectively.

关 键 词：支气管肺囊肿 诊断 鉴别诊断 外科手术 

分 类 号：R734.2[医药卫生—肿瘤]