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作 者:方程远 张金峰 杨英男 姜浩[1] 辛衍忠 张鲁权 李蕙颖 刘鑫 马建群[1] Fang Chengyuan;Zhang Jinfeng;Yang Yingnan;Jiang Hao;Xin Yanzhong;Zhang Luquan;Li Huiying;Liu Xin;Ma Jianqun(Department of Thoracic Surgery Esophageal Mediastinal,the Affiliated Tumor Hospital of Harbin Medical University,Harbin 150001,China)
机构地区:[1]哈尔滨医科大学附属肿瘤医院胸外科食管纵隔病房,150001
出 处:《中华胸心血管外科杂志》2020年第11期664-667,共4页Chinese Journal of Thoracic and Cardiovascular Surgery
摘 要:目的探讨支气管源性囊肿的诊断方法、临床特点及治疗方案的选择。方法选取哈尔滨医科大学附属肿瘤医院2011年1月至2020年5月经术后病理证实的支气管源性囊肿患者86例,食管囊肿5例。支气管源性囊肿男37例,女49例;年龄23~70岁,平均(49.27±10.70)岁。根据发病位置分为纵隔型65例(75.6%),肺内型21例(24.4%);起源于食管的支气管源性囊肿(9例10.5%)。结果术前明确诊断8例(9.3%)。胸腔镜手术51例(59.3%),对比开胸手术,术后胸腔引流管留置时间[(3.80±1.25)天对(4.97±1.54)天,P<0.001]和住院时间[(7.08±1.75)天对(9.60±2.58)天,P<0.001]明显缩短。随访65例(71.4%,65/91),中位随访34(2~111)个月,均未见复发。结论支气管囊肿无特征性临床表现,术前明确诊断较为困难,胸部MRI对囊肿的诊断有较大优势;对于大多数病例,胸腔镜手术可以达到较好的临床治疗效果,并具有微创优势。起源于食管的支气管源性囊肿与食管囊肿术前鉴别困难,临床特点无明显差异。Objective To discuss the diagnostic methods,clinical features and treatment options of bronchogenic cysts.Methods A total of 86 patients with bronchogenic cysts and 5 patients with esophageal cysts and esophageal cysts were selected from January 2011 to May 2020 in the Affiliated Tumor Hospital of Harbin Medical University.There were 37 males and 49 females with bronchogenic cysts,aged 23 to 70(49.27±10.70)years old.According to the location of the disease,the patients were divided into mediastinal type(65 cases,75.6%);intrapulmonary type(21 cases,24.4%);bronchogenic cyst originating from the esophagus(9 cases,10.5%).Results The preoperative diagnosis coincidence rate was 9.3%in 8 cases.The rate of thoracoscopic surgery(59.3%in 51 cases),compared with the indwelling time of thoracic drainage tube after thoracotomy[(3.80±1.25)days vs.(4.97±1.54)days,P<0.001]and hospital stay[(7.08±1.75)days vs.(9.60±2.58)days,P<0.001]significantly shortened.65 cases(71.4%,65/91)were successfully followed up,with a median follow-up time of 34(2-111)months,and no recurrence was found.Conclusion Bronchial cysts have no characteristic clinical manifestations,and it is difficult to make a clear diagnosis before surgery.Chest MRI has a great advantage in the diagnosis of cysts.For most cases,thoracoscopic surgery can achieve better clinical treatment results and has minimally invasive advantages.It is difficult to distinguish between bronchogenic cysts that originated in the esophagus and esophageal cysts,and there is no significant difference in clinical characteristics.
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