Hong Chun, Yu Gang, Tang Jing, Liu QianLi, Xia Bo
Department of Pediatric thoracic Surgery, Guangdong Women and Children Hospital and Health Institute, Women and Children Hospital Affiliated to Guangzhou Medical College, No. 521, Xingnan Road, Panyu District, Guangzhou, 511400, China.
Pediatr Surg Int. 2017 Sep;33(9):971-975. doi: 10.1007/s00383-017-4097-0. Epub 2017 Jun 19.
Researched and discussed the risks and outcomes of bronchopulmonary sequestrations, especially the intralobar type.
A retrospective review of our experiences with bronchopulmonary sequestrations from January 2012 to April 2015 is reported. The present study researched and discusses the risks and outcomes of bronchopulmonary sequestrations, especially the intralobar type, compared with other types of bronchopulmonary sequestrations in symptoms, surgery, pathology, and excretion.
A total of 126 bronchopulmonary sequestrations were diagnosed. All fetal chest cases (18-30 weeks) of solid or high-echo masses were diagnosed antenatally and then confirmed by ultrasound. Enhanced computed tomography was used to confirm the diagnosis. Eighty-three boys and 43 girls were included. The mean age at surgery was 4.2 ± 0.5 months. There were 103 cases of left, 22 cases of right, and 1 case of bilateral sequestration. There were 62 extralobar cases, 51 intralobar cases, 13 cases within the diaphragm, and a rare bilateral case. A preoperative history of recurrent respiratory tract infection was present in 39 cases, including 10 extralobar and 29 intralobar cases. Operations were completed successfully, and diagnoses were confirmed pathologically. Thirty-seven cases were associated with congenital bronchopulmonary malformation changes, of which 4 were extralobar, 31 were intralobar, and 2 were within the diaphragm.
The intralobar type was relatively uncommon among bronchopulmonary sequestrations. However, due to communication with normal lung tissue, infection is common in the intralobar type. Computed tomography examinations are very important immediately after birth. It is necessary to resect the mass in early childhood.
对肺隔离症的风险及治疗结果进行研究和讨论,尤其针对叶内型肺隔离症。
报告了2012年1月至2015年4月间我们对肺隔离症的治疗经验回顾。本研究对肺隔离症,尤其是叶内型肺隔离症的风险及治疗结果进行了研究和讨论,并与其他类型的肺隔离症在症状、手术、病理及排泄方面进行了比较。
共诊断出126例肺隔离症。所有产前超声诊断为实性或高回声肿块的胎儿胸部病例(孕18 - 30周)均在出生后经超声检查确诊。增强计算机断层扫描用于确诊。纳入83例男孩和43例女孩。手术平均年龄为4.2±0.5个月。左侧103例,右侧22例,双侧1例。叶外型62例,叶内型51例,膈肌内13例,罕见双侧病例。39例有反复呼吸道感染的术前病史,其中叶外型10例,叶内型29例。手术均成功完成,病理确诊。37例伴有先天性支气管肺畸形改变,其中叶外型4例,叶内型31例,膈肌内2例。
叶内型肺隔离症在肺隔离症中相对少见。然而,由于与正常肺组织相通,叶内型肺隔离症感染常见。出生后应立即进行计算机断层扫描检查。儿童早期切除肿块很有必要。