Rupprecht E, Dietzsch H J, Wunderlich P
Z Erkr Atmungsorgane. 1982;159(2):194-202.
Within 20 years 22 children with congenital lobar emphysema were observed. 13 children were infants, 9 were already older than a year, thus, clearly deviating from the age structure reported in literature. 15 children underwent an operation, in 2 children the alterations disappeared completely respectively partially. One child prematurely born died before operation. The upper lobe was concerned most frequently (11 times), followed by the right upper lobe (6 times) and the right middle lobe (4 times). Bronchoscopy was showing in surprising frequency a stenosis of the trachea (2 times) respectively of the main bronchus (7 times). In 13 of 15 cases bronchographically investigated the displacement and compression of the adjacent lobar bronchi were predominant. The regression of the emphysema observed in a x-ray picture series initially with an "opaque lung" and later on with spontaneous disappearance of the lobar emphysema is more fully described. In the opinion of the authors the analysis of their cases is justifying a change in the conception concerning age structure and urgency of surgery. Bronchological examination is considered of importance for differential diagnostics especially to delimit cystic pulmonary alteration.
20年间共观察了22例先天性肺叶气肿患儿。13例为婴儿,9例年龄超过1岁,这明显不同于文献报道的年龄结构。15例患儿接受了手术,2例患儿的病变分别完全或部分消失。1例早产患儿在手术前死亡。上叶受累最为常见(11次),其次是右上叶(6次)和右中叶(4次)。支气管镜检查显示气管狭窄(2次)或主支气管狭窄(7次)的频率令人惊讶。在15例接受支气管造影检查的病例中,13例主要表现为相邻肺叶支气管的移位和受压。文中更全面地描述了在X线片系列中观察到的肺气肿的消退情况,最初表现为“肺不透明”,随后肺叶气肿自发消失。作者认为,对他们病例的分析证明有必要改变关于年龄结构和手术紧迫性的观念。支气管检查对于鉴别诊断尤其是区分囊性肺部病变很重要。