保留肺叶治疗PryceⅠ型肺隔离症10例报告  

Transection of Aberrant Systemic Artery Without Lobectomy for Pryce TypeⅠPulmonary Sequestration:Report of 10 Cases

作　　者：徐晓辉[1] 周小昀[1] 马冬捷[1] 陈野野[1] 王力 崔玉尚[1] Xu Xiaohui;Zhou Xiaoyun;Ma Dongjie(Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医院胸外科,北京100730

出　　处：《中国微创外科杂志》2022年第6期481-485,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨保留肺叶只离断异常体循环动脉血管治疗PryceⅠ型肺隔离症的可行性。方法回顾性分析我院2015年1月~2020年9月10例PryceⅠ型肺隔离症临床资料。胸腔镜异常体循环动脉血管离断术8例,降主动脉内覆膜支架植入异常动脉隔绝术2例,受异常动脉滋养的肺叶均得以保留。结果10例手术均获成功。术后血红蛋白下降值(16.7±13.3)g/L(0~39 g/L)。5例术后最高体温>38℃。术后随访8~63个月,中位数47个月,均恢复良好,未再出现咯血症状,无明显胸腰部不适,复查CT未见保留肺叶有缺血相关的囊性变或纤维化,各肺叶均未见肺气肿样改变。结论PryceⅠ型肺隔离症可以通过胸腔镜或介入的方法只离断异常动脉血管而不切除受累肺叶。Objective To investigate the feasibility of transection of aberrant systemic artery without lobectomy for Pryce typeⅠpulmonary sequestration.Methods A retrospective analysis was made on 10 cases of Pryce typeⅠpulmonary sequestration in our hospital from January 2015 to September 2020.Eight patients underwent thoracoscopic surgery for aberrant systemic arterial dissection,and two patients received covered stent implantation for occlusion of aberrant systemic artery in descending thoracic aorta.Lung lobes nourished by aberrant arteries were preserved.Results All the operations were successful.The average hemoglobin decline after operation was(16.7±13.3)g/L(range,0-39 g/L).There were 5 cases that had the highest postoperative body temperature above 38℃.All the patients were followed up for 8-63 months,with a median follow-up time of 47 months.All the patients recovered well without hemoptysis or obvious chest and lumbar discomfort.No ischemia related cystic change or fibrosis was found in the reserved lung lobes on CT re-examination,and no emphysema-like change was found in all lung lobes.ConclusionPryce typeⅠpulmonary sequestration can be treated by transection of aberrant systemic artery alone without lobectomy through thoracoscopy or interventional therapy.

关 键 词：肺隔离症 PryceⅠ型 保留肺叶 胸腔镜手术 介入治疗 

分 类 号：R73[医药卫生—肿瘤]