右肺中叶病变的临床特征分析（附709例报告）

Analysis of clinical characteristics of middle lobe lesions in the right lung (709 cases)

摘要:

目的 探讨右肺中叶支气管异常患者的人口学特征、临床表现、病因、影像学表现和支气管镜下表现。方法 回顾性分析2015年5月－2025年4月于该院在支气管镜检查中表现为右肺中叶异常改变的709例患者的临床资料，统计分析病因和临床特征。结果 709例患者中，男465例，女244例。男患者年龄（63.1±9.1）岁，明显高于女患者的年龄（60.9±11.5）岁，差异有统计学意义（P < 0.05）。临床表现主要包括：咳嗽、气促、咯血、痰中带血和胸痛，9.9%的患者未出现临床症状。根据年龄范围进行分组，将年龄 > 55岁的542例（76.4%）患者纳入高龄组，≤55岁的167例（23.6%）患者纳入低龄组，高龄患者明显多于低龄患者，差异有统计学意义（P < 0.05）。高龄组中，常见的3种病因分别为：肿瘤、炎症和结核。支气管镜下表现为：右中叶新生物、黏膜肥厚或肿胀、管腔狭窄和瘢痕闭塞等。结论 右肺中叶病变的患者采用影像学和支气管镜相结合的方式，对明确病因和指导临床治疗有重要意义。

Abstract:

Objective To explore the demographic characteristics, clinical manifestations, etiology, imaging findings and bronchoscopic manifestations of patients with abnormal bronchoscopic findings in the right middle lobe bronchus.Methods A retrospective analysis was conducted on the clinical data of 709 patients who showed abnormal changes in the right middle lobe during bronchoscopy from May 2015 to April 2025. The etiology and clinical characteristics were statistically analyzed.Results Among the 709 patients, 465 were male and 244 were female. The age of male patients was (63.1 ± 9.1) years, which was significantly higher than that of female patients (60.9 ± 11.5) years, and the difference was statistically significant (P < 0.05). The clinical manifestations mainly included cough, short breath, hemoptysis, blood in sputum and chest pain. 9.9% of the patients had no clinical symptoms. Grouping was conducted based on age range. A total of 542 patients (76.4%) aged > 55 years were included in the elderly group, which was significantly more than the 167 patients (23.6%) aged ≤ 55 years in the younger group, and the difference was statistically significant (P < 0.05). In the elderly group, the three common causes were tumors, inflammation and tuberculosis. Under bronchoscopy, it could be manifested as neoplasia in the right middle lobe, mucosal hypertrophy or swelling, lumen stenosis and scar occlusion, et al.Conclusion For patients with middle lobe lesions of the right lung, the combination of imaging and bronchoscopy is of great significance for clarifying the cause and guiding clinical treatment.