Nazem Masood, Hosseinpour Mehrdad
Trauma Research Centre, Kashan University of Medical Sciences (KAUMS), Iran.
Afr J Paediatr Surg. 2010 Sep-Dec;7(3):144-6. doi: 10.4103/0189-6725.70412.
Congenital lobar emphysema (CLE) is characterised by over distension of one lobe and pressure on the adjacent lobe and mediastinum. In this study, we review the pathological results of our paediatric patients with CLE, highlighting the early and late complications that occurred in these patients.
In a prospective study from 1996 to 2008, we evaluated 30 patients with CLE diagnosis. Variables collected included sex, age at the time of diagnosis, radiological diagnostic method, type of treatment, pathological analysis, surgical findings and early postoperative complications. Parents were asked to refer to our clinic for follow-up and evaluation of late complications.
Thirty patients and males accounted for majority of the study population (n = 20, 67%). The mean age of male and female patients (at admission) was 7.2 ± 2.3 and 4.7 ± 1.2 months respectively (P = not significant). The main diagnostic method was chest x-ray (CXR) in all patients. Abnormal bronchial cartilage was found in 71% of patients. The most affected lobe was left upper lobe (50%). Associated anomalies were seen in four patients. Early postoperative periodhadtwo cases of pneumothoraces. At six month follow up, five (25%) males and four females (40%) had delayed weight gain. Permanent oxygen dependency was seen in two patients. Twenty- six patients underwent thoracotomy. Mortality rate was 13%. Base deficit at the time of admission was greater in those patients who eventually died, (-8.6 ± 1.2 versus -3.1 ± 0.4) (P = 0.0003). There were two deaths in the bilobar involvement group and two in the unilobar involvement group (P = 0.07, near significant).
This study confirms that the number of affected lobes and base deficit at the time of admission were associated with significantly increased mortality.
先天性肺叶气肿（CLE）的特征是一个肺叶过度膨胀，并对相邻肺叶和纵隔产生压迫。在本研究中，我们回顾了儿科CLE患者的病理结果，重点关注这些患者出现的早期和晚期并发症。
在一项1996年至2008年的前瞻性研究中，我们评估了30例诊断为CLE的患者。收集的变量包括性别、诊断时的年龄、放射学诊断方法、治疗类型、病理分析、手术结果及术后早期并发症。我们要求家长带孩子到我们诊所进行随访及评估晚期并发症。
30例患者中男性占研究人群的大多数（n = 20，67%）。男性和女性患者（入院时）的平均年龄分别为7.2±2.3个月和4.7±1.2个月（P = 无显著差异）。所有患者的主要诊断方法是胸部X线（CXR）。71%的患者发现支气管软骨异常。最常受累的肺叶是左上叶（50%）。4例患者伴有其他异常。术后早期有2例气胸。在6个月的随访中，5名（25%）男性和4名女性（40%）体重增加延迟。2例患者出现永久性氧依赖。26例患者接受了开胸手术。死亡率为13%。最终死亡的患者入院时的碱缺失更大（-8.6±1.2对比-3.1±0.4）（P = 0.0003）。双叶受累组和单叶受累组各有2例死亡（P = 0.07，接近显著）。
本研究证实，受累肺叶数量及入院时的碱缺失与死亡率显著增加相关。
