右中叶综合征外科治疗的十年经验
Ten years' experience in surgical treatment of right middle lobe syndrome.
作者信息
Pejhan Saviz, Salehi Farshid, Niusha Shanay, Farzanegan Behrooz, Sheikhy Kambiz
机构信息
Tracheal Diseases Research Center, National Research institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Ann Thorac Cardiovasc Surg. 2015;21(4):354-8. doi: 10.5761/atcs.oa.14-00273. Epub 2015 Mar 2.
PURPOSE
In this study we present the clinical, radiological, pathological, bronchoscopic and surgical results of 40 patients with diagnosis of middle lobe syndrome who were referred to our thoracic surgery unit for surgical intervention in a 10 years period.
METHODS
Forty patients with obstructive and non-obstructive causes of middle lobe syndrome referred to our thoracic surgery unit. Clinical data were collected from the patients' records in a ten years period. This study evaluates diagnostic approaches and surgical treatments in right middle lobe syndrome.
RESULTS
We studied 23 females (57.5%) and 17 males (42.5%) with a mean age of 31.7. Clinical findings were cough 95%, sputum 80% and intermittent hemoptysis in 50% of patients. Middle lobe collapse was seen in CT scan of all patients. Bronchiectasis was the most common pathologic finding (55%). Tuberculosis was not rare and was final pathology in 20% of patients. In three patients ruptured hydatid cyst was final finding. Surgery was done without mortality and with only minor complications.
CONCLUSION
Lobectomy of right middle lobe is a good therapeutic option in these patients. Due to high prevalence of tuberculosis and hydatid cyst in Middle Eastern countries these two must be considered as causes of middle lobe syndrome.
目的
在本研究中，我们展示了40例被诊断为中叶综合征的患者在10年期间转诊至我们胸外科接受手术干预的临床、放射学、病理学、支气管镜检查及手术结果。
方法
40例因阻塞性和非阻塞性原因导致中叶综合征的患者转诊至我们胸外科。在十年期间从患者记录中收集临床数据。本研究评估右中叶综合征的诊断方法和手术治疗。
结果
我们研究了23名女性（57.5%）和17名男性（42.5%），平均年龄为31.7岁。临床症状为咳嗽（95%）、咳痰（80%），50%的患者有间歇性咯血。所有患者的CT扫描均显示中叶肺不张。支气管扩张是最常见的病理表现（55%）。肺结核并不少见，20%的患者最终病理诊断为此病。3例患者最终诊断为破裂的包虫囊肿。手术无死亡病例，仅有轻微并发症。
结论
右中叶肺叶切除术对这些患者是一种很好的治疗选择。由于中东国家肺结核和包虫囊肿的高发病率，这两者必须被视为中叶综合征的病因。
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