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題名 | 右中葉徵候群--案例報告暨文獻回顧=Right Middle Lobe Syndrome A Case Report and Literatures Review |
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作者 | 李建中; 蔣士仁; | 書刊名 | 胸腔醫學 |
卷期 | 12:3 1997.09[民86.09] |
頁次 | 頁134-140 |
分類號 | 415.426 |
關鍵詞 | 右中葉徵候群; 肺膨脹不全; 支氣管鏡檢查; 支氣管攝影術; 側枝通氣; R't middle lobe syndrome; RMLS; Atelectasis; Bronchoscopy; Bronchography; Collateral ventilation; |
語文 | 中文(Chinese) |
中文摘要 | 本案例為42歲女性,主要症狀為咳嗽、有痰、流鼻水、喉嚨痛及發燒。胸部X光檢 查顯示右中葉塌陷,支氣管鏡檢查發現右中葉支氣管遭到氣管外壓迫,胸部電腦斷層檢查顯 示一鈣化淋巴結壓迫右中葉支氣管。內科保守及抗結核藥物治療後症狀持續,於是施行胸部 切開及右中葉切除術。 右中葉徵候群是一個以右中葉重複性膨脹不全、發炎到支氣管擴張為特徵的疾病群,它 可以發生在任何年齡層的病人身上,但以中年人居多。致病機轉目前仍未十分明瞭,但以非 阻塞理論(測枝通氣不良)解釋較為合理。支氣管鏡檢及支氣管攝影術為此症不可或缺的必 要檢查。許多原因皆可引發此症。初步治療以抗生素及物理治療為主,若懷疑或證實此症為 惡性因子所引發、或有嚴重出血情形、或內科處理後肺膨脹不全、發炎仍持續復發時應考慮 進行外科手術治療。 |
英文摘要 | A 42-year-old female presented with the symptom of cough with sputum, rhinorrhea, sore throat and followed by fever. CxR showed RML collapse. Broncho- scopy showed external compression of bronchus on R't middle lobe orifice. CT scan of chest showed a calcified lymph node compress the bronchus of RML. Beucase patient refused surgical intervention, anti-TB chemotherapy were prescribed. Unfortunately, the symptom persisted, thoracotomy with lobectomy of RML was done. Right middle lobe syndrome (RMLS) is characterized by a spectrum of disease from recurrent atelectasis and pneumonitis to bronchiectasis of the middle lobe. It had been described in all age groups, and the majority of those reported have been middleage adults. Its mechanism is uncertain, but the non-obstructive (impaired collateral ventilation) theory appeared to be the most plausible. Bronchoscopy and bronchography are vital in the rational approach to this syndrome. Multiple lesions had been identified as the cause of RMLS. Antibiotics and physical therapy are the mainstays of initial therapy. Surgery is indicated for suspected or proved of malignancy, severe bleeding, and an inflammatory process or atelectasis that failed to response to medical management. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。