孤立性肺结节的诊治分析  

Diagnosis and surgical treatment of solitary pulmonary nodules

作　　者：杨永辉[1] 李欣欣[2] 郝孟辉[1] 温永富[1] 

机构地区：[1]河北省唐山市开滦总医院胸心外科,063000 [2]河北省唐山市开滦总医院肿瘤科,063000

出　　处：《临床外科杂志》2016年第11期856-858,共3页Journal of Clinical Surgery

摘　　要：目的：总结孤立性肺结节（SPN）的诊断和治疗体会。方法回顾性分析我院2010年1月-2014年5月手术治疗的120例 SPN 患者的临床资料。结果术后病理检查提示良性病变30例，包括结核瘤10例，错构瘤8例，炎性假瘤6例，硬化性血管瘤2例，肺囊肿2例，霉菌球1例，淋巴结1例；恶性病变90例，包括腺癌56例，鳞癌26例，腺鳞癌3例，小细胞癌1例，大细胞癌1例，转移癌3例。SPN 良、恶性患者年龄、临床症状、吸烟指数、结节直径、毛刺分叶症、结节边界、胸膜牵拉、胸膜皱缩比较差异有统计学意义（P ＜0.05）。结论患者年龄、临床症状、吸烟指数、结节直径、毛刺分叶症、结节边界模糊、胸膜牵拉、胸膜皱缩对判断 SPN 的良恶性有重要意义；对于可疑恶性病变者，应积极手术治疗。Objective To investigate the diagnosis and treatment of the solitary pulmonary nod-ules（SPN）. Methods From January 2010 to May 2014,the clinical and pathological data of 120 pa-tients of SPN were retrospectively analyzed. Results Benign lesions were diagnosed by postoperative pa-thology in 30 cases,including 10 cases of tuberculoma,8 cases of hamartoma,6 cases of inflammatory pseudotumor,2 cases of sclerosing hemangioma,2 case of pulmonary cyst,1 case of fungal ball,and 1 case of lymph node;malignant lesions were diagnosed postoperatively in 90 cases,including 56 cases of adeno-carcinoma,26 cases of squamous cell carcinomas,3 cases of adenosquamous carcinoma,1 case of small cell carcinoma,1 case of large cell cancer,and 3 cases of metastatic lung cancer. There were significant differences in age,clinical symptoms,smoking history,nodule diameter,speculation and lobulation,nodule boundary,pleural retraction,and pleural shrinkage of the patients（P 〈 0. 05）. Conclusion Age,nodule diameter,speculation and lobulation,nodule boundary,pleural retraction,and pleural shrinkage are the predictors of malignancy in patients with SPN. For suspected malignant lesions,surgical treatment should be taken.

关 键 词：孤立性肺结节 诊断 手术 

分 类 号：R655.3[医药卫生—外科学]