复杂性肺包虫囊肿的表现、诊断、处理和结果

Manouchehr Aghajanzadeh, Ali Alavi Foumani, Azita Tangestaninejad, Seyed Aliaskhar Fakher Mosavi, Zahra Sadin, Omid Mosaffaee Rad, Ehsan Hajipour, Alireza Shirzadi, Mohaya Farzin
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摘要

导言导言:导言:复杂性肺包虫囊肿是指任何在支气管树或胸膜腔内破裂、感染的囊肿,很少发生在心包腔内。本研究旨在评估复杂性肺包虫囊肿的问题,包括表现、诊断、手术方法的选择以及肺包虫囊肿手术治疗延误的并发症。方法:2016年至2021年期间,192例肺水瘤囊肿患者接受了手术治疗,其中42例患者为复杂性肺水瘤囊肿。所有患者的手术方式均为后外侧胸廓切开术和前外侧胸廓切开术;8 例患者为膈肌切开术,6 例患者为一期双侧胸廓切开术。结果:18 名患者(67.5%)为单发包虫囊肿,4 名患者(32.5%)为多发包虫囊肿,12 名患者为双侧包虫囊肿,8 名患者同时患有肺、肝和其他器官包虫囊肿,6 名患者术前有包虫囊肿病史。4 名患者的完整包虫囊肿发生了先天性破裂。6 名患者(27%)明显受累于胸腔外。4 名患者(16%)明显受累于胸腔内但肺外。结论并发包虫囊肿可能表现为原发性肺肿瘤、胸腔积液、肺水肿、气胸等不同的临床和影像学表现。在地方病流行地区有可疑肺部肿块或有包虫囊肿病史的患者,可将并发肺包虫囊肿列入鉴别诊断。
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Presentation, diagnosis, management and outcome of complicated hydatid cyst of the lung
Introduction: Introduction: The complicated hydatid cyst of the lung is defined as any cyst ruptured in the bronchi tree or in the pleural cavity, infected, and rarely in the pericardial cavity. The aim of this study was to evaluate the problems of complicated pulmonary hydatid cyst, including presentation, diagnosis choice of surgical methods. and complication of delay in surgical treatment of pulmonary hydatid cysts. Methods: Between 2016 and 2021, 192 operations operated for pulmonary hydatid cysts, 42 of these patients were complicated hydatid cyst. Presentations were cough, chest pain and dyspnea.Diagnosis tools were CXR and CT-scan of chest. surgical approach was a posterolateral thoracotomy and anterolateral thoracotomyin all patients; a phrenotomy in eight patients and one-stage bilateral thoracotomy in six patients. Results: In 18 patients (67.5%), there were single hydatid cysts; whereas 4 patients (32.5%) had multiple cysts.12 patients had bilateral cyst and 8 had both lung and liver and others organs, 6 patients had preoperative hydatid cyst history. Iatrogenic rupture of an intact hydatid cyst occurred in 4 patients. Extrathoracic involvement was apparent in 6 patients (27%). Intrathoracic but extrapulmonary involvement was apparent in 4 patients (16%). Conclusion: Complicated hydatid cyst may present with different clinical and radiologically manifestations as a primary lung tumor , pleural effusion ,empyema hydropneumothorax. In patients with suspicious lung masses in endemic area or history of a hydatid cyst in patients a complicated pulmonary hydatid cyst may be in differential diagnosis.
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