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25例成人肺隔离症的临床表现及特征

Clinical presentation and characteristics of 25 adult cases of pulmonary sequestration.

作者信息

Polaczek Mateusz, Baranska Inga, Szolkowska Malgorzata, Zych Jacek, Rudzinski Piotr, Szopinski Janusz, Orlowski Tadeusz, Roszkowski-Sliz Kazimierz

机构信息

Third Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland.

Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.

出版信息

J Thorac Dis. 2017 Mar;9(3):762-767. doi: 10.21037/jtd.2017.03.107.

Abstract

BACKGROUND

Pulmonary sequestration (PS) is a rare congenital abnormality of lung tissue. Only few series of adult cases are reported. The aim was to describe clinical characteristics in adult cases of PS and to compare outcomes in different clinical situations.

METHODS

Using MSD engine we searched for cases of PS that have been diagnosed between Jan 1st, 2005 and Dec 31st, 2015. Clinical data was retrospectively gathered. Statistica v.12 (StatSoft, Inc.) was used for statistical analyses.

RESULTS

We found 25 cases (18 females, 7 males), which underwent surgery and were histologically proven. There were 22 cases of intralobar PS. 7 cases were asymptomatic, 12 had infectious history (including 3 cases of lung abscess and pleural empyema), 4 presented with hemoptysis, 2 with chest pain. The average age to undergo surgery was 38.24, in the asymptomatic group 34, in symptomatic 39.89. In the latter the symptoms preceded the surgery for 2.45-year. Great majority of sequestrations was located in lower lobes (96%), 52% on the left. Symptomatic cases were at higher than expected risk of surgical complications, comparing to asymptomatic (chi, P=0.04). In most cases there were surgical and histological signs of infection, only in 9 cases etiological factor was determined: in 5 cases it was . A 0.53-day longer post-surgical hospital stay was observed in the symptomatic group, no statistical significance was found (U-test, P=0.45).

CONCLUSIONS

Surgical treatment of symptomatic cases of PS is characterized by slightly longer post-surgical hospital stay and higher risk of surgical complications. Fungal infections are the most likely to occur in PS.

摘要

背景

肺隔离症(PS)是一种罕见的肺组织先天性异常。仅有少数关于成人病例的系列报道。目的是描述成人PS病例的临床特征,并比较不同临床情况下的治疗结果。

方法

使用MSD引擎检索2005年1月1日至2015年12月31日期间诊断为PS的病例。回顾性收集临床数据。使用Statistica v.12(StatSoft公司)进行统计分析。

结果

我们发现25例(18例女性,7例男性)接受了手术且经组织学证实。其中22例为叶内型PS。7例无症状,12例有感染史(包括3例肺脓肿和胸膜脓胸),4例咯血,2例胸痛。手术平均年龄为38.24岁,无症状组为34岁,有症状组为39.89岁。有症状组症状出现至手术的时间为2.45年。绝大多数隔离灶位于下叶(96%),52%位于左侧。与无症状组相比,有症状组手术并发症风险高于预期(卡方检验,P = 0.04)。大多数病例有手术和组织学感染迹象,仅9例确定了病因:5例为……。有症状组术后住院时间长0.53天,但差异无统计学意义(U检验,P = 0.45)。

结论

有症状的PS病例手术治疗的特点是术后住院时间稍长且手术并发症风险较高。真菌感染是PS中最可能发生的。

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本文引用的文献

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Pulmonary sequestration in adult patients: a retrospective study.成人患者的肺隔离症:一项回顾性研究。
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