LUNG SEQUESTRATION - REPORT OF 7 CASES AND REVIEW OF 540 PUBLISHED CASES
LUNG SEQUESTRATION - REPORT OF 7 CASES AND REVIEW OF 540 PUBLISHED CASES
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DOI：
10.1136/thx.34.1.96
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发表时间：
1979-01-01
期刊：
影响因子：
10
通讯作者：
KNOCHE, R
中科院分区：
文献类型：
--
作者：
SAVIC, B;BIRTEL, FJ;KNOCHE, R
本文分析了400例叶内型和133例叶外型肺隔离症，其中6例同时表现为叶内型和叶外型肺隔离症，5例为全肺型肺隔离症，2例为双侧叶内型肺隔离症。这种异常占所有先天性肺畸形的0.15-6.4%。通常累及后基底段。叶内型肺隔离症的迷走动脉74%起源于胸主动脉，14.8%有1支以上的迷走动脉。迷走动脉平均直径为6.3- 6.6mm，以弹性纤维为主，动脉粥样硬化性病变常见，儿童也有。叶内隔离症的静脉回流，在95.7%的所有病例中，通过肺静脉。在13.7%的病例中观察到其他先天性畸形。37.2%的患者在出生后10年内出现症状。支气管造影和逆行动脉造影是诊断的主要方法。隔离物不是由支气管动脉供应的。首选的治疗方法是尽早手术。共报告了7例手术死亡，其中5例是由于术中出血。133例叶外隔离症中，77.4%位于膈与下叶之间。动脉血供由主动脉分支提供。部分病例由肺动脉分支提供静脉血。6例继发结核或癌，60%的患者症状发生在10岁以内。术前诊断正确者仅6例。术后死亡4例。
An analysis of 400 intralobar and 133 extralobar sequestrations, 6 cases presenting intra- and extralobar sequestration simultaneously, 5 sequestrations of 1 whole lung and 2 bilateral intralobar sequestrations, was presented. This anomaly comprised 0.15-6.4% of all congenital pulmonary malformations. Usually the posterior basal segment was affected. The aberrant artery in intralobar sequestration originated in 74% of all cases from the thoracic aorta, and in 14.8% there was more than 1 anomalous artery. The mean diameter of the aberrant arteries was 6.3-6.6 mm. Usually arteries with predominantly elastic fibers were found. Arteriosclerotic changes were common, even in children. The venous return of the intralobar sequestration was, in 95.7% of all cases, via the pulmonary veins. In 13.7% of all cases other congenital malformations were observed. Symptoms arose within the 1st decade of life in 37.2%. Bronchography and retrograde arteriography were the mainstay of diagnosis. Sequestrations were not supplied by a bronchial artery. Treatment of choice was operation as early as possible. Altogether 7 operative deaths were reported, 5 of which were due to hemorrhage during surgery. Of the 133 extralobar sequestrations, 77.4% were located between diaphragm and lower lobe. The arterial supply was provided by branches of the aorta. Some cases were supplied with venous blood by branches of the pulmonary artery. In 6 cases secondary changes, such as tuberculosis or carcinoma were found. In 60% of all the patients symptoms occurred within the 1st decade of life. Preoperative diagnosis was correct in only 6 cases. There were 4 postoperative deaths.