儿童先天性肺囊肿性病变51例的回顾性分析  

A Retrospective Analysis of 51 Children with Congenital Cystic Lung Lesions

作　　者：盛安群 张维溪[1] 张雪雅[1] 赵志光[1] 李昌崇[1] 

机构地区：[1]温州医科大学附属育英儿童医院呼吸科,325000

出　　处：《医学研究杂志》2014年第3期113-116,共4页Journal of Medical Research

基　　金：卫生部国家临床重点专科(温州医科大学附属育英儿童医院呼吸科)开放课题基金资助项目

摘　　要：目的探讨51例儿童先天性肺囊肿性病变的临床特点、诊断及手术治疗情况，提高对该病的诊疗水平。方法回顾性分析温州医科大学附属育英儿童医院2000年1月-2013年7月51例经手术和病理证实的先天性肺囊肿性病变患儿的临床特点、影像学表现、病理学资料、诊断及治疗方法。结果支气管源性囊肿28例（54．90％），先天性囊性腺瘤样畸形9例（17．65％），肺隔离症11例（21．57％），先天性大叶性肺气肿1例（1．96％），先天性囊性腺瘤样畸形合并肺隔离症2例（3．92％），36例（70．59％）患者临床表现为肺部感染；影像学检查结果，支气管源性囊肿可表现为气囊肿、液囊肿、液气囊肿，其中以气囊肿最多见，占53．57％；先天性囊性腺瘤样畸形可表现为大囊型、小囊型、实性型，而以大囊型为主，占55．6％；肺隔离症者以肺部团块密度增高影为主，先天性大叶性肺气肿表现为肺过度充气，内可见稀疏的肺纹理。术前误诊率为15．70％，所有患者均行手术治疗，肺叶切除术39例（76．47％），囊肿摘除术者7例（13．73％），行隔离肺切除术5例（9．80％），总体预后良好。结论先天性肺囊肿性病变以支气管源性囊肿为主要类型，临床表现以肺部感染为主，临床上误诊率较高，影像学表现多样，影像学检查是术前诊断的重要依据，手术是其安全有效的治疗方式。Objective To investigate the clinical characteristics, diagnosis and surgical procedures of congenital cystic lung lesions in children for enhancing the diagnosis and treatment of the congenital cystic lung lesions. Methods Fifty one patients with congenital cystic lung lesions were recruited from the inpatient department of Yuying Children＇s Hospital Affiliated to Wenzhou University from Janu- ary 2000 to July 2013. The clinical characteristics, radiographic findings, histopathology, diagnosis and treatment were analyzed. Results There were 28 cases（54.90% ） of bronchogenic cyst, 9 cases（ 17.65% ） of congenital cystic adenomatoid malformation, 11 caeses （21.57%） of pulmonary sequestration, 1 case（ 1.96% ） of congenital lobar emphysema and 2 cases（3.92% ） of mixed - type lesions （congenital cystic adenomatoid malformation with pulmonary sequestration）. A total of 36 cases （70.59%） manifested as lung infections. Bronchogenic cyst was showed as air - filled cyst, fluid - filled cyst and cyst containing air and fluid in radiographic findings, in which air - filled cyst was the most common accounting for 53.57%. The radiographic findings of congenital cystic adenomatoid malformation could be large cyst, small cyst and solid lesion,in which the large cyst was the most common radiographic findings accounting for 55.56%. Pul- monary sequestration was usually demonstrated as the mass lesion with increased opacity and congenital lobar emphysema was the overin- flated lobe with attenuated lung markings in radiographic findings. The misdiagnosis rate was 15.70%. All cases received surgical resec- tion which contanin lobectomy in 39 cases（76.47% ）, cystectomy in 7 cases（ 13.73% ） and sequestrectomy in 5 cases（9.80% ）. The outcome was good in general. Conclusion The main type of congenital cystic lung lesions is hronchogenic cyst and the most common clin- ical presentation is lung infection. The preoperative diagnosis may be incorrect. Radiographic findings are diverse and play impo

关 键 词：儿童 先天性肺囊肿性病变 诊断治疗 

分 类 号：R726[医药卫生—儿科]