【摘要】 目的 提高肺隔离症诊断水平。方法 回顾既往确诊的1例特殊的肺隔离症患者临床资料。结果 男性66岁患者因间断胸闷胸痛半年加重3 d以冠心病不稳定型心绞痛收住院，住院期间行冠状动脉CT血管造影未发现明显冠状动脉狭窄，同时发现由冠状动脉发出的异常支气管动脉引流分支形成冠状动脉窃血。曾诊断为支气管扩张症，住院期间再度出现咯血，呼吸科会诊考虑肺隔离症可能性大，行胸部增强CT发现肺内及肺外型肺隔离症同时存在，遂确诊。误诊时间40年。建议行异常支气管动脉封堵术，但患者拒绝，自动出院。出院后随访2年患者一般情况可，未再咯血，偶有心前区不适。结论 接诊双下肺内带出现囊状或实变影患者，应警惕肺隔离症的可能。更多还原

【Abstract】 Objective To improve the diagnostic level of pulmonary sequestration. Methods The clinical data of a special case of pulmonary sequestration was reviewed. Results A 66-year-old male patient was admitted to the hospital due to intermittent chest tightness and chest pain for 6 months and aggravation for 3 days. During hospitalization, coronary CT angiography showed no obvious coronary artery stenosis, and coronary steal was found by abnormal bronchial artery drainage branch from the coronary artery. The patient was diagnosed with bronchiectasis, but hemoptysis recurred during hospitalization. The respiratory consultation considered the possibility of pulmonary sequestration, and chest enhanced CT showed the presence of both pulmonary and extrapulmonary pulmonary sequestration. The duration of misdiagnosis was 40 years. Abnormal bronchial artery occlusion was recommended, which was declined by the patient, who was discharged voluntarily. The patient was followed up for 2 years after discharge, and the general condition of the patient was good, with no hemoptysis and occasional precordial discomfort.Conclusion Possibility of pulmonary sequestration should be considered in patients with cystic or consolidation in the inner zone of both lower lungs.更多还原