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2014-12-18 4:13 am
A focal consolidation patch with emphysematous bordering was found in the medial inferior aspect of the right lower lung, and was supplied possibly by 2 aberrant arteries from the right side of the celiac trunk. Pulmonary sequestration of the posteromedial basal lung was suspected, due to the imaging findings.此病灶
Thoracoscopic wedge resection of the right lower lung pulmonary sequestration was carried out following the chest CT.
During the operation, right basal lung consolidation with an obstructed bronchial lumen and frank pus accumulation was noted. A feeding artery that originated from the paraesophageal side of the celiac artery was ligated. Pathology reported a whitish fibrotic pulmonary tissue, measuring 9.8× 5.5 × 3.2 cm, and the microscopic evaluation was compatible with pulmonary sequestration.
No malignant cells or evidence of congenital pulmonary airway malformation (CPAM) could be seen in the specimen. The operative findings and pathology report were compatible with ILS.
There was no recurrence of hemoptysis during the 2-month postoperative follow-up, and the patient did not experience copious sputum production as before. Medical control with hemostatics and antibiotics was no longer required.
Pulmonary sequestration is traditionally classified as ILS or extralobar pulmonary sequestration (ELS), based on its pleural investment. By definition, ILS is located within a normal lobe and lacks its own visceral pleura, and ELS is found outside the normal lung and has its own pleura. Some experts have proposed bronchopulmonary-foregut malformation as another variant when the sequestered lung is connected to the gastrointestinal tract [2].
Of the various congenital anomalies of the lung, BPS accounts for 0.15-6.4% of all malformations [3]. ILS is more common by far and comprises 75-90% of all BPS [3-4]. ILS affects males and females equally, but there is a significant male predominance in ELS [1-2].

回答 (3)

2014-12-18 5:39 am
✔ 最佳答案
甲焦固結補丁與肺氣腫接壤被發現在右下肺的內側劣方面中,並且被從右側腹腔**可能供給由2異常動脈。後內側基底肺肺隔離症被懷疑,由於影像表現。此病灶
胸腔鏡楔形切除右下肺肺隔離症進行了以下的胸部CT。
在操作過程中,右側基底節肺實有阻塞支氣管腔及膿液坦誠積累指出。這起源於腹腔動脈的食管旁A面供血動脈結紮。病理報告了發白纖維化肺組織,測量9.8×5.5×3.2厘米×和微觀評價為與肺隔離兼容。
無惡性細胞或先天性肺呼吸道畸形(CPAM)的證據可以看出,在標本。手術結果和病理報告是與ILS兼容。
有在2個月的術後隨訪未見復發咯血,病人並沒有像以前那樣豐富的經驗痰。不再需要醫療控制止血藥和抗生素。
肺隔離症傳統上劃分為ILS或葉外型肺隔離症(ELS)的基礎上,其胸腔的投資。根據定義,ILS坐落在一個正常的肺葉,缺乏自身的臟層胸膜,並ELS是正常肺外發現並擁有自己的胸膜。一些專家提出支氣管-前腸畸形作為另一種變型,當隔離肺連接到胃腸道的[2]。
肺的各種先天性異常,BPS佔所有畸形[3]的0.15-6.4%。 ILS是比較常見的由遠及包括所有BPS[3-4]75-90%。 ILS影響男性和女性同樣的,但有一個顯著男性居多在ELS[1-2]。
2015-08-19 5:09 pm
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2014-12-18 12:43 pm

在右下肺的中下部位發現帶有氣腫的間質斑塊病灶並且可能經由右側腹腔的2條迷動脈供血 基於此影像的發現 懷疑是中後底肺部的肺游離

循胸部掃描執行右下肺游離肺的胸腔鏡楔形切除手術

手術中有看到右肺底間質有一阻塞的支氣管聚集了大量的膿液 來自腹腔動脈側食道邊的一條供血動脈被結紥了 病理報告為一發白纖維性的肺組織 尺寸9.8x5.5x3.2cm 顯微評估也合乎游離肺

檢驗的採樣裏沒看見惡性細胞或先天性肺氣道畸形 手術中的發現和病理檢驗報告都合乎ILS(肺葉內游離肺)

手術之後的2個月追蹤裏 沒有再發生咳血 病人不再像以前那麽多痰 止血藥和抗生素的藥物控制不再需要了

傳統上 把游離肺以其肋膜包圍狀態分類為ILS(葉內游離)及 ELS(葉外游離)以定義論 ILS是位於一片正常肺葉內缺乏自己的臟器肋膜 而ELS是出現於正常的肺外面擁有自己的肋膜 有些專家曾提議認為游離肺與腸胃道有連結的肺支氣管-前腸畸形算是另一種變型

在各種肺的先天異常中 BPS(游離肺)佔所有畸形的0.15-6.4% 葉內游離最為常見 居所有BPS的75-90% 葉內游離發生於男性和女性一樣多 但是在葉外游離 男性有顯著的超越


以上供參


收錄日期: 2021-04-27 21:38:24
原文連結 [永久失效]:
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