Mattila S P, Ketonen P E, Kyllönen K E
Ann Chir Gynaecol Fenn. 1975;64(1):24-9.
31 surgically treated cases of pulmonary sequestration are reported. There were 23 of intralobar and 8 of extralobar type, 23 were on the left and 8 on the right. All but three had symptoms most of them pointing to a respiratory tract infection. Six patients had pneumonia, five haemoptyses, three patients pleurisy and two patients empyema before the operation. In addition to chest x-ray, aortogram appeared to be the most valuable tool in providing the accurate diagnosis preoperatively. Most of the cases were treated by lobectomy, in 7 cases by sequestrectomy and in 2 cases by pneumonectomy. One of the patients died from pulmonary infarction due to anomalous ipsilateral pulmonary venous draingae and ligation of the veins by oversight during right lower lobectomy. The rest of the patients recovered uneventfully. On microscopical examination of the specimens a case of aspergillosis was noted, which has not been described previously in the literature in association of pulmonary sequestration. In one case acid-fast bacteria were found in the necrotic mass of the cavities in the sequestration.
报告了31例接受手术治疗的肺隔离症病例。其中叶内型23例,叶外型8例;左侧23例,右侧8例。除3例外,其余均有症状,多数提示呼吸道感染。6例患者术前有肺炎,5例咯血,3例胸膜炎,2例脓胸。除胸部X线检查外,主动脉造影似乎是术前提供准确诊断最有价值的工具。大多数病例采用肺叶切除术治疗,7例采用隔离肺切除术,2例采用全肺切除术。其中1例患者因同侧肺静脉异常引流,在右下肺叶切除术中因疏忽结扎了静脉,死于肺梗死。其余患者均顺利康复。在对标本进行显微镜检查时,发现1例曲霉菌病病例,此前文献中未将其与肺隔离症相关联进行描述。在1例病例中,在隔离肺空洞的坏死组织中发现了抗酸杆菌。