摘要
目的 探讨支气管Dieulafoy病临床表现、诊断及治疗方法.方法 结合我院收治的1例支气管Dieulafoy病的临床资料及国内外文献报道的病例进行综合分析.结果 患者男性,70岁,反复间断咯血30年,大咯血8 h住院,胸部平片及CT未发现异常,行支气管检查发现气管黏膜呈＂蚯蚓＂样突起,活检过程中突然出现大出血窒息,经抢救复苏成功,后经病理及肺血管造影证实气管黏膜血管异常,考虑支气管Dieulafoy病,行栓塞治疗后好转.结论 支气管Dieulafoy病文献报道较少,发病原因不详,可能与支气管肺动脉先天发育异常和（或）后天的慢性炎症刺激、损伤有关,文献报道少可能与认识不足有关.遇有不明原因大咯血需行气管镜检查时,气管镜检查发现气管黏膜呈＂蚯蚓＂样突起,应想到该病的可能,不要盲目活检,应想到有大咯血窒息可能,如确需活检,应备好抢救措施.
Objective To explore the clinical characteristics, diagnosis and therapy of Dieulafoy＇s disease of the bronchus. Methods The clinical data of one patient with Dieulafoy＇s disease of the bronchus in our hospital were described and relevant literatures were reviewed. Results The male patient of 70 years old was hospitalized for repeated and intermittent hemoptysis for 30 years and massive hemoptysis for eight hours. Chest X-ray and computer tomography were normal. Bronchoscopic examination showed that tracheal mucosa was earthworm-like protrusion. The patient choked due to massive hemoptysis during biopsy. After successful resuscitation, pathology and pulmonary angiography confirmed vascular of tracheal mucosa was abnormal. Dieulafoy＇s disease of the bronchus was considered and the condition improved after embolotherapy. Conclusions Dieulafoy＇s disease of the bronchus is extremely rare, the etiology is still unknown. It may be related to bronchial pulmonary artery congenital dysplasia and （or）acquired chronic inflammation and injury. The scarce of case reports is corelated with neglection of the disease. For the patients with cryptogenic hemoptysis,if bronchoscopic examination shows tracheal mucosa is earthworm-like protrusion,Dieulafoy＇s disease of the bronchus should be considered. Biopsy must be not made blindly,otherwise the patients may choke due to massive hemoptysis. If biopsy is really necessary,rescue measures should be ready for.
出处
《国际呼吸杂志》
2010年第24期1495-1497,共3页
International Journal of Respiration
关键词
咯血
支气管
活检
窒息
Hemoptysis
Bronchus
Biopsy
Choke
