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中华胸部外科电子杂志 ›› 2017, Vol. 04 ›› Issue (01) : 27 -30. doi: 10.3877/cma.j.issn.2095-8773.2017.01.06

所属专题: 文献

论著

肺隔离症的诊断及不同外科治疗方法的效果比较
范海洋1, 李明彪1, 张宏毅1, 韦森1, 陈钢1, 徐嵩1,(), 陈军1,()   
  1. 1. 300052 天津医科大学总医院肺部肿瘤外科
  • 收稿日期:2016-10-20 出版日期:2017-02-28
  • 通信作者: 徐嵩, 陈军
  • 基金资助:
    国家自然科学基金(81301812,81172233); 高等学校博士学科点专项科研基金(20131202120004); 天津自然科学基金重点项目(12JCZDJC24400)

Diagnosis of pulmonary sequestration and comparison of surgical treatment

Haiyang Fan1, Mingbiao Li1, Hongyi Zhang1, Sen Wei1, Gang Chen1, Song Xu1,(), Jun Chen1,()   

  1. 1. Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
引用本文:

范海洋, 李明彪, 张宏毅, 韦森, 陈钢, 徐嵩, 陈军. 肺隔离症的诊断及不同外科治疗方法的效果比较[J/OL]. 中华胸部外科电子杂志, 2017, 04(01): 27-30.

Haiyang Fan, Mingbiao Li, Hongyi Zhang, Sen Wei, Gang Chen, Song Xu, Jun Chen. Diagnosis of pulmonary sequestration and comparison of surgical treatment[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2017, 04(01): 27-30.

目的

探讨肺隔离症的诊断方法,并比较传统开胸手术与胸腔镜手术的疗效。

方法

收集2009年10月至2016年1月在天津医科大学总医院收治并同意行手术治疗的18例患者临床资料,其中7例行胸腔镜手术,11例行开胸手术。比较两组患者的平均年龄、手术时间、术中出血量、术后引流量、术后引流天数、有无术后并发症、术后住院天数以及总住院费用。

结果

胸腔镜组术后平均引流时间和住院时间均短于开胸组,差异有统计学意义(t=4.553,P<0.05;t=5.068;P<0.05)。但两组患者的平均年龄、手术时间、术中出血量和总住院费用比较,差异均无统计学意义(P>0.05)。诊断主要依靠胸部影像学诊断,特别是胸部增强CT及三维重建血管成像,能够发现异常动脉血管影;尤其是多排螺旋CT扫描更能明显减少三维重建产生的伪影,使图像更接近于真实,再结合患者既往病史即可初步诊断。

结论

胸腔镜治疗肺隔离症安全、可靠,术后恢复快、伤口美观,值得推广和应用。

Objective

To investigate the diagnosis of pulmonary sequestration, and compare the therapeutic effects between open chest surgery and thoracoscopic surgery for pulmonary sequestration.

Methods

The clinical data of 18 patients with pulmonary sequestration undergoing surgical treatments in Tianjin Medical University General Hospital between October 2009 and January 2016 were retrospectively analyzed, including 7 cases of thoracoscopic surgery and 11 cases of open surgery. The mean age, operation time, volume of intraoperative blood loss, time of postoperative drainage, volume of postoperative drainage, occurrence of postoperative complications, postoperative hospitalization time and total hospitalization expenses were compared between two groups.

Results

The mean time of postoperative drainage and hospitalization in thoracoscopic surgery group was significantly shorter than that in open chest surgery group(t=4.553, P<0.05; t=5.068, P<0.05). However, there was no significant difference in mean age, operation time, volume of intraoperative blood loss and total hospitalization expenses between two groups(P>0.05). The diagnosis was mainly based on chest imaging diagnosis, especially chest enhanced CT and three-dimensional reconstruction of blood vessel imaging, which revealed abnormal arteries. In particular, multi-slice spiral CT scan significantly reduced the artifacts of three-dimensional reconstruction, which made the image closer to reality. Then, the preliminary diagnosis was formed on the basis of previous disease history.

Conclusions

Thoracoscopic surgery is safe and reliable to treat pulmonary sequestration with thoracoscopic surgery, which is worthy of widely application.

图1 3例入组患者的术前胸部CT影像。A:术前诊断为肺隔离症(箭头为丛降主动脉异常发出的血管);B:术前诊断为支扩继发感染;C:术前诊断考虑良性病变,未明确
表1 开胸组和胸腔镜组患者的相关指标比较((±s)
1
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