首页|成人肺隔离症131例诊治的回顾性分析

成人肺隔离症131例诊治的回顾性分析

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目的 探讨单孔胸腔镜能否成为肺隔离症有效的治疗方式.方法 回顾性分析上海市肺科医院胸外科2010年2月—2021年6月诊断为肺隔离症并行手术切除患者的临床资料.根据手术方式将患者分为胸腔镜组和开胸组,对两组手术时间、术中出血量、住院时间及术后并发症发生率等进行分析,并对胸腔镜组进行亚组(单孔胸腔镜组和多孔胸腔镜组)分析.结果 纳入患者131例,其中男62例、女69例,平均年龄(39.3±13.2)岁.胸腔镜组103例,开胸组28例.左下肺隔离症104例,右下肺隔离症26例,双下肺隔离症1例.咳嗽(88例,67.2%)为主要临床症状.术前119例行胸部增强CT检查确诊.胸腔镜组和开胸组手术时间差异无统计学意义(P=0.717),而胸腔镜组术中出血量、术后住院时间、术后并发症发生率比开胸组更有优势,差异有统计学意义(P<0.05).另外在亚组分析中单孔胸腔镜组与多孔胸腔镜组术中中转开胸的比例分别为11.8%和13.5%.同时单孔胸腔镜组术中出血量比多孔胸腔镜组少,术后并发症发生率比多孔胸腔镜组低,且手术时间、术后住院时间比多孔胸腔镜组短,差异有统计学意义(P<0.05).结论 为提高肺隔离症术前诊断准确率,胸部增强CT可作为成人疑似病例(尤其是下叶肺出现囊实性或实性病变)的首选检查方法.对于肺隔离症,单孔胸腔镜是一种安全有效的治疗方式,值得推广.
Diagnosis and treatment of 131 adult patients with bronchopulmonary sequestration:A retrospective analysis
Objective To explore the safety and feasibility of uni-portal video-assisted thoracic surgery(VATS)for the treatment of bronchopulmonary sequestration(BPS).Methods The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed.The patients were divided into a VATS group and a thoracotomy group according to the operation method.The operation time,intraoperative blood loss,hospital stay and postoperative complication rate were compared between the two groups.The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis.Results Finally 131 patients were enrolled,including 62 males and 69 females with an average age of 39.3±13.2 years.There were 103 patients in the VATS group and 28 patients in the thoracotomy group.A total of 104 patients were diagnosed with left lower BPS,26 with right lower BPS and 1 with bilateral lower BPS.The main symptom was cough(88 patients,67.2%).There were 119 patients diagnosed by thoracic enhanced CT before operation.Compared with the thoracotomy group,the operation time was not statistically different(P=0.717),but the blood loss was less,the rate of postoperative complication was lower and hospital stay was shorter in the VATS group(P<0.05).The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8%and 13.5%,respectively.Meanwhile,patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay,less blood loss and lower postoperative complication rate than those in the multi-portal VATS group(P<0.05).Conclusion In order to improve the rate of diagnosis,the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients(especially those with solid cystic and solid lesions in the lower lobe).Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.

Bronchopulmonary sequestrationuni-portal video-assisted thoracic surgerythoracotomy

顾小波、陈乾坤、万紫薇、叶聪、朱余明、杜仕建

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四川省人民医院温江医院成都市温江区人民医院胸外科(成都 644100)

同济大学附属上海市肺科医院胸外科(上海 200433)

肺隔离症 单孔胸腔镜 开胸手术

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(1)
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