临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (1): 16-.doi: 10.3969/j.issn.1000-3606.2020.01.004

• 呼吸系统疾病专栏 • 上一篇    下一篇

儿童先天性肺气道畸形20 例临床分析

刘新锋, 刘晓娟, 赵志妙, 张中平   

  1. 河北医科大学附属河北省儿童医院(河北石家庄 050031)
  • 出版日期:2020-01-15 发布日期:2020-02-03

Clinical analysis of congenital pulmonary airway malformation in 20 children

 LIU Xinfeng, LIU Xiaojuan, ZHAO Zhimiao, ZHANG Zhongping   

  1. Children's Hospital of Hebei Province Affiliated to Hebei Medical University, Hebei 050031, Shijiazhuang, China
  • Online:2020-01-15 Published:2020-02-03

摘要: 目的 总结儿童先天性肺气道畸形(CPAM)的临床特点。方法 回顾分析2016年1月至2018年12月诊断为 CPAM的20例患儿临床资料。结果 20例患儿中,男12例、女8例,平均年龄(30.4±7.6)个月;病程5天~3年。17例表 现为反复咳嗽、喘息、发热, 1例表现为胸闷, 2例表现为呼吸困难。双侧病变4例;单侧病变16例,累及左侧7例,右侧9例。 合并心脏畸形2例, 1例为三房心。肺高分辨CT检查14例患儿表现为大囊型,均伴有纵隔移位; 6例为小囊型。术后病理分型, Ⅰ型14例,Ⅱ型5例,Ⅳ型1例。所有患儿均手术治疗,术后随访时间1~24个月不等,均恢复良好。结论 CPAM少见,可 合并其他系统畸形,可通过肺部高分辨CT检查发现,确诊需依据病理组织学检查,经手术治疗后预后较好。

关键词: 先天性肺气道畸形; 临床特点; 儿童

Abstract: Objective To explore the clinical characteristics of congenital pulmonary airway malformation (CPAM) in children. Methods The clinical data of CPAM in 20 children from January 2016 to December 2018 were analyzed retrospectively. Results In the 20 children (12 males; 8 females) aged 30.4±7.6 months in average, the course of the disease ranged from 5 days to 3 years. Seventeen patients presented with recurrent cough, wheezing and fever, one presented with chest distress, and two presented with dyspnea. Bilateral lesions were found in 4 cases. There were 16 cases with unilateral lesion including 7 cases of left involvement and 9 cases of right involvement. Two children were complicated with cardiac malformations, and one had the triatrial heart. High resolution CT examination of the lung revealed large cystic type in 14 patients, mediastinal displacement in all patients , and small cystic type in 6 patients. Postoperative pathological classification showed 14 cases of type I, 5 cases of type II and 1 case of type IV. All the children received surgical treatment, and the postoperative follow-up time varied from 1 to 24 months. All children recovered well. Conclusions CPAM is rare and can be combined with other system deformities which can be found by high-resolution CT of the lung. The confirmation of diagnosis of CPAM should be based on the histopathological examination, and the prognosis is good after the operation.

Key words: congenital pulmonary airway malformation; clinical feature; child