肺隔离症一例误诊分析

摘要

目的 探讨肺隔离症(pulmonary sequestration,PS)的临床特点及误诊原因.方法 对我院收治的误诊为其他疾病的1例PS临床资料进行回顾性分析.结果 本例因反复咳嗽、咳痰、咯血10年,复发3 d入院.曾就诊多家医院,误诊为支气管扩张症、肺结核、肺癌,予相关治疗后症状未见明显好转.入院后经实验室及CT增强扫描后多层面图像重建(MPR)、最大密度投影(MIP)、容积再现重组(VR)等处理,确诊为右下肺背段PS(异常供血动脉来源于腹主动脉上段),予抗感染、化痰、止血治疗,咯血停止后出院.随访1年,患者无咳嗽、咳痰等症状.结论 临床遇及反复咳嗽、咳痰、咯血且久治不愈的患者时,要考虑到PS可能,及时行相关医技检查,争取早期确诊,以减少误诊误治,改善预后.%Objective To discuss clinical characteristics and misdiagnosed causes of pulmonary sequestration ( PS) . Methods Clinical data of 1 patient with PS, who was misdiagnosed as having other diseases, was retrospectively analyzed. Results The patient was admitted for repeated cough, expectoration and haemoptysis for 10 years and recurrence for 3 d, The patient was misdiagnosed as having bronchiectasis, tuberculosis and lung cancer in other hospitals, but the patient's symptoms did not obviously improved after related treatments. Right lower lung epimere PS ( abnormal feeding artery from superior seg-ment of abdominal aorta) was diagnosed after treatments such as laboratory and CT contrast enhanced scan, multi-level picture reconstruction ( MPR) , maximum intensity projection ( MIP) and volume reappearance restructuring ( VR) . The patient was treated with anti-infection, eliminate sputum and hemostasis, and the patient was discharged after hemoptysis was stopped. With follow-up for one year, no symptoms such as cough or expectoration were found. Conclusion When patients have re-peated cough, expectoration and hemoptysis with incurability, clinicians have taken into account the PS, and give relevant medical examinations in time in order to confirm the diagnosis as early as possible to avoid misdiagnosis and mistheapy and im-prove prognosis.