婴儿先天性大叶性肺气肿1例及文献分析  

A case of congenital lobar emphysema in infants and literature analysis

作　　者：朱彩霞 任瑞娟[1] 王志远 李树军[1] ZHU Caixia;REN Ruijuan;WANG Zhiyuan;LI Shujun(Department of pediatrics,The First Affiliated Hospital of Xinxiang Medical College,Henan Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院儿科,河南卫辉453100

出　　处：《中国妇幼健康研究》2020年第8期1121-1123,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的先天性大叶性肺气肿(CLE)在婴儿期较少见,但严重威胁婴儿生命。本文旨在探讨该病的临床特性及诊断治疗情况。方法对新乡医学院第一附属医院收治的1例CLE婴儿进行病例报告和临床分析,结合已有的国内外文献,深入探讨其临床特点、辅助检查及诊疗方法。结果 CLE在婴儿期发病率较低,为1/20 000~1/30 000,男女发病比例为3∶1;主要病理改变为肺叶的过度膨胀和扩张,目前病因尚不明确;临床表现多样,25%~33%的患儿生后即出现刺激性咳嗽、呼吸困难、喘息、负荷性青紫,进而呼吸窘迫,甚至危及生命;X线、胸部CT及产前超声可帮助诊断,病变多位于上肺叶,以左上肺叶为主,其次是右肺上叶和中叶,可行手术切除治疗,术后恢复良好。结论 CLE容易误诊,X线、胸部CT及产前超声可帮助诊断,一旦确诊应尽早手术,微创胸腔镜下手术效果及预后较好。Objective Congenital lobar emphysema(CLE) is rare in infancy,but it is a serious threat to infant life.This article aims to discuss the clinical characteristics and diagnosis and treatment of the disease.Methods A case report and clinical analysis of a CLE infant admitted to the First Affiliated Hospital of Xinxiang Medical College were conducted,combined with the existing domestic and foreign literatures,to discuss its clinical characteristics,auxiliary examination and diagnosis and treatment methods.Results The incidence of CLE is relatively low in infancy,ranging from 1/20,000 to 1/30,000,and the incidence ratio of male to female is 3∶1.The main pathological changes are excessive expansion and dilatation of pulmonary lobes,the cause of which was not clear at present.The clinical manifestations are various.After birth,25%~33% of the infants immediately show irritant cough,dyspnea,wheezing,and heavy blue,and then respiratory distress or even life-threatening symptoms.X-ray,chest CT and prenatal ultrasound can help diagnose.The lesions are mostly located in the upper lobe of the lung,mainly in the left upper lobe,followed by the right upper lobe and middle lobe of the lung.Surgical resection is feasible and postoperative recovery is good.Conclusion CLE is easy to be misdiagnosed,and X-ray,chest CT and prenatal ultrasound can help diagnose.Surgery should be performed as soon as possible once the diagnosis is confirmed.Minimally invasive thoracoscopic surgery has a good effect and prognosis.

关 键 词：婴儿 先天性肺气肿 影像学检查 手术 

分 类 号：R725.6[医药卫生—儿科]