摘要
目的探讨支气管镜对骨化性气管支气管病的诊治价值，提高对该病的认识。方法对中南大学湘雅医院呼吸科支气管镜室2006年6月至2007年7月收治的10例骨化性气管支气管病患者的临床症状、支气管镜下表现、组织病理结果及支气管镜下治疗经过和疗效进行回顾性研究。结果10例中男8例，女2例，年龄33—76岁，平均（46±16）岁。支气管镜下可见大小不一的结节凸向管腔，沿气管、支气管纵向分布，主要累积气管和主支气管，叶、段支气管较少累积；7例结节局限于气道前侧壁，3例同时累及后侧壁。按结节分布密度将其分为3型：分散型、弥漫型和融合型，分别为3例、5例和2例。6例接受治疗的患者中2例选用等离子射频治疗，4例选用氩气刀治疗。术中及术后均未出现严重并发症。治疗后患者气道内结节较治疗前减少，临床症状改善。结论骨化性气管支气管病易误诊、漏诊；支气管镜联合组织病理检查是确诊的最佳手段；支气管镜下等离子射频和氩气刀治疗是有效的姑息治疗手段。
Objective To enhance the knowledge of tracheobronchopathia osteochondroplastica （TO）, and to describe the value of flexible bronchoscopic diagnosis and treatment for the disease. Methods The clinical data, bronchoscopic findings, histological results and the methods and effect of bronchoscopic treatment in 10 patients with TO admitted to Xiangya Hospital between June 2006 and July 2007 were retrospectively analyzed. Results There were 8 males and 2 females （ mean age 46 ＋ 16, range 33 - 76 years）. The bronchoscopic appearance of TO was multiple whitish, hard nodules projecting into the tracheal lumen （mostly from the anterior and less from the lateral walls）. The lesions were found most frequently in the trachea and major bronchi, and lobar and segmental bronchi were involved less frequently. Nodules were restricted to the anterolateral walls in 7 cases. The distribution of the lesions was diffuse in 5, confluent in 2 and scattered in 3 cases. Six patients received bronchoscopic management, including radiofrequency treatment for 2 patients and argon ion laser treatment for the other d. The lesions in the airways were reduced and clinical symptoms improved to some extent after treatment. No severe complications occurred during and after the procedures. Conclusions The diagnosis of TO can be easily underdiagnosed or misdiagnosed. Flexible bronchoscopy with histological examination is the main method for the diagnosis of TO. Radiofrequency and argon ion laser treatment are safe and effective.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2009年第7期489-492,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
支气管镜检查
骨化性气管支气管病
等离子射频
氩气刀
Tracheobronchopathia osteochondroplastica
Bronehoscopy
Radiofrequency
Argon ion laser
