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目的总结肺硬化性血管瘤(PSH)的临床特点、诊断及外科治疗疗效。方法回顾分析2009年1月-2013年8月接受手术治疗的PSH患者32例的临床资料。结果 32例患者均经胸部增强CT明确肺部包块。其中14例开放行肺叶或包块楔形切除,18例电视辅助胸腔镜手术(VATS)下行肺叶、肺段或包块楔形切除术。手术均顺利完成,无围手术期死亡。术后病理及免疫组织化学均确诊为PSH。肿瘤直径1.5~10.0 cm。随访0.5~4年未发现复发及转移病例。结论 PSH无特异性临床表现及影像学特征,术后病理及免疫组织化学是唯一确诊依据。手术治疗是有效安全的治疗手段,预后良好。建议采用VATS手术方式,可不常规清扫淋巴结。
Objective To summarize the clinical features, diagnosis and surgical treatment of pulmonary sclerosing hemangioma (PSH). Methods The clinical data of 32 patients with PSH treated surgically from January 2009 to August 2013 were retrospectively analyzed. Results Thirty-two patients were confirmed by thoracic enhanced CT. Among them, 14 cases underwent open lobectomy or mass wedge resection and 18 cases underwent VATS for wedge resection of the lung, pulmonary segment or mass. All the operations were successfully completed without perioperative death. Postoperative pathology and immunohistochemistry were diagnosed as PSH. Tumor diameter 1.5 ~ 10.0 cm. Follow-up 0.5 to 4 years, no recurrence and metastasis were found. Conclusion PSH has no specific clinical manifestations and imaging features. Postoperative pathology and immunohistochemistry are the only evidence of diagnosis. Surgical treatment is effective and safe treatment, the prognosis is good. VATS surgery is recommended, not routine lymph node dissection.