摘要
隔離肺為一少見之先天性肺部異常，其特性為由無功能性肺臟組織所形成之病灶，且與正常之呼吸道沒有相連結，並擁有其獨立之血液循環系統。本文收集三軍總醫院，從1983 年至1994年之隔離肺患者共五位。收集資料包括性別、年齡、症狀、放射學檢查及手術發現。每位患者診斷均有病理學診斷。五例經手術後証實為隔離肺之病例，其中男性3例，女性2例，平均年齡為26.8歲。其臨床症狀以反覆性肺炎最為常見。放射學檢查以肺部X光與動脈血管攝影來診斷隔離肺，有很高之診斷率。所有病例均接受手術切除，且手術後，患者症狀改善，無任何併發症。因此，當患者有反覆性肺炎且單側下肺野有不正常病灶，常須考慮此一疾病。再加以配合動脈血管攝影，為診斷本疾病之主要利器。手術切除病灶為唯一的治療方法。
並列摘要
Pulmonary sequestration is an extremely uncommon anomaly characterized by nonfunctioning abnormal pulmonary parenchyma that has no connection with the tracheobronchial airway and receives its blood supply from a systemic artery. The authors collected five patients with intralobar pulmonary sepuestration at Tri-Service General Hospital (TSGH) from 1983 to 1994. The data included: age, sex, clinical symptoms and results of radiological investigations. Operative treatment and findings were evaluated. Diagnosis was confirmed histologically in each case. Five patients included 2 females and 3 males. Their ages ranged from 15 years to 44 years (mean age 26.8 years). The symptoms included: recurrent pneumonia (2 cases), pleuritis (1 case), chronic cough (1 case), and no symptoms (1 case). Chest radiographs showed homogeneous consolidation or cystic lung lesion, and was first impressed correctly in two. Three patients were misdiagnostic for pulmonary sequestration by CT scan. Arteriography was done in three cases. The results were consistent with the pulmonary sequestration. Ultrasonography was performed in one and yielded inconsistent. All patients received surgical intervention, lobectomies in four and segmentectomy in one, without morbidity or mortality. All patients had intralobar sequestration. Their arterial vessels originated from thoracic in two; abdominal aorta in two; unknown in one. All patients had free symptoms after operation at least one year follow-up. Conclusively, when patients present with recurrent pulmonary infection and abnormal chest radiography, a detailed investigation is warranted. The most informative radiological investigations are the chest radiography and arteriography. Definitive diagnosis is made at thoracotomy. Resection of the involved lung demonstrates excellent relief of symptoms and the long-term outcome is highly favorable.
延伸閱讀
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