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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Acute chest syndrome shows a predilection for basal lung regions on the side of upper abdominal surgery: (Le syndrome pulmonaire aigu montre une predilection pour les regions basales du poumon du cote de la chirurgie abdominale haute).
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Acute chest syndrome shows a predilection for basal lung regions on the side of upper abdominal surgery: (Le syndrome pulmonaire aigu montre une predilection pour les regions basales du poumon du cote de la chirurgie abdominale haute).

机译：急性胸腔综合症显示出上腹部手术侧的基底肺区域偏爱：

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PURPOSE: Upper abdominal surgery for cholecystectomy or splenectomy is the most frequently performed surgical procedure in patients with sickle cell disease (SCD). The acute chest syndrome (ACS) is the most common sickle-related postoperative complication. The objective of the study was to characterize the clinical and radiological presentation of ACS complicating cholecystectomy and splenectomy. METHODS: The medical records of all children with SCD undergoing cholecystectomy or splenectomy during the 15-year period from January 1988 through December 2002 were reviewed. Patients who experienced ACS within 14 days after surgery were identified. Data collected included demographics, perioperative management, clinical and radiological findings, and outcome. RESULTS: The overall incidence of postoperative ACS was 16%, occurring in nine of 51 patients having cholecystectomy and in seven of 48 patients having splenectomy. Mean time to onset of symptoms was 49 hr after surgery (range, 24-96 hr). Cough, fever,and an abnormal chest examination were documented for all patients at presentation. Radiologically, ACS involved the basal lobes in all cases and was multi-lobar in 25%. Patients were more likely to have new infiltrates involving the lung on the side of the surgery or bilateral infiltrates than isolated contralateral infiltrates at presentation (P < 0.0001). Isolated upper or middle lobe involvement did not occur. Fifty percent of cases demonstrated evidence of a pleural effusion. CONCLUSION: ACS complicating cholecystectomy or splenectomy shows a predilection for basal lung regions and for the lung on the side of surgery. These results have implications for the pathogenesis and prevention of postoperative ACS.
机译：目的：对于镰状细胞病（SCD）患者，最常进行的手术是胆囊切除术或脾切除术的上腹部手术。急性胸综合症（ACS）是最常见的与镰刀相关的术后并发症。这项研究的目的是表征ACS并发胆囊切除术和脾切除术的临床和影像学表现。方法：回顾性分析了从1988年1月到2002年12月这15年中所有接受了胆囊切除术或脾切除术的SCD儿童的病历。确定在手术后14天内经历ACS的患者。收集的数据包括人口统计学，围手术期管理，临床和放射学发现以及结果。结果：术后ACS的总发生率为16％，发生在51例胆囊切除术患者中的9例和48例脾切除术中的7例。症状发作的平均时间为手术后49小时（范围24-96小时）。所有患者均出现咳嗽，发烧和胸部异常检查。放射学上，ACS在所有病例中均累及基底叶，多叶占25％。与就诊时分离的对侧浸润相比，患者在手术侧发生新的浸润或双侧浸润的可能性更高（P <0.0001）。没有发生孤立的上或中叶受累。 50％的病例显示出胸腔积液的证据。结论：ACS并发胆囊切除术或脾切除术显示基底肺区域和手术侧肺部表现良好。这些结果对术后ACS的发病机理和预防意义重大。

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