CAJ | 학술논문

目的提高对成人支气管异物的认识和诊治水平,避免长期误诊、误治.方法回顾我院收治的1例长期误诊支气管异物成年患者病历资料,并复习相关文献,探讨成人支气管异物在临床症状、胸部影像学及支气管镜下的不典型表现以及造成患者长期误诊、误治的原因.结果成年患者,近4年反复咳嗽、咯痰、喘憋,影像学上有弥漫性磨玻璃影、多发支气管扩张及斑片影等多种表现,曾行支气管舒张试验阳性,严重时曾行气管插管,入我院后行支气管镜检查确诊为右中间段支气管异物,后长期随访患者临床表现、影像学及肺功能检查已治愈.结论成年患者常无明确异物吸入史,临床症状不典型,影像学常无异物存在直接征象,容易造成临床误诊、误治,支气管镜对成人支气管异物的诊治有重要价值.
목적 제고대성인지기관이물적인식화진치수평,피면장기오진、오치.방법 회고아원수치적1례장기오진지기관이물성년환자병력자료,병복습상관문헌,탐토성인지기관이물재림상증상、흉부영상학급지기관경하적불전형표현이급조성환자장기오진、오치적원인.결과 성년환자,근4년반복해수、각담、천별,영상학상유미만성마파리영、다발지기관확장급반편영등다충표현,증행지기관서장시험양성,엄중시증행기관삽관,입아원후행지기관경검사학진위우중간단지기관이물,후장기수방환자림상표현、영상학급폐공능검사이치유.결론 성년환자상무명학이물흡입사,림상증상불전형,영상학상무이물존재직접정상,용역조성림상오진、오치,지기관경대성인지기관이물적진치유중요개치.
Objective To improve the understanding,diagnosis and treatment of adult patient with bronchial foreign body,avoiding long-term misdiagnosis and inappropriate treatment.Methods The clinical data of one adult patient with bronchial foreign body misdiagnosed for four years was analyzed retrospectively.Literature was reviewed.The atypical clinical manifestation,imaging and bronchoscopy of patient with bronchial foreign body were explored.The causes of long-term misdiagnosis and inappropriate management of bronchial foreign body were discussed.Results The clinical manifestation of one adult patient included recurrent cough,sputum and wheezing.CT scan showed diffuse ground-glass opacity,multiple bronchiectasis and patch shadow.Bronchial dilation test was positive.Tracheal intubation was underwent in extreme case.Bronchoscopy indicated right middle segmental bronchial foreign body.The symptoms were relieved greatly by removing the foreign body and proper medications,and the imaging and pulmonary function tests were also improved during a long-term follow-up.Conclusions Absent of foreign body inhaling history,atypical clinical symptoms and imaging features are main causes of misdiagnosis and inappropriate management in adult patients.Bronchoscopy plays an important role in the diagnosis and treatment of bronchial foreign body in adults.