国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2010年
24期
1495-1497
,共3页
丁东%芦丽%帅智创%董会生%刘英
丁東%蘆麗%帥智創%董會生%劉英
정동%호려%수지창%동회생%류영
咯血%支气管%活检%窒息
咯血%支氣管%活檢%窒息
각혈%지기관%활검%질식
Hemoptysis%Bronchus%Biopsy%Choke
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.
目的 探討支氣管Dieulafoy病臨床錶現、診斷及治療方法.方法 結閤我院收治的1例支氣管Dieulafoy病的臨床資料及國內外文獻報道的病例進行綜閤分析.結果 患者男性,70歲,反複間斷咯血30年,大咯血8 h住院,胸部平片及CT未髮現異常,行支氣管檢查髮現氣管黏膜呈"蚯蚓"樣突起,活檢過程中突然齣現大齣血窒息,經搶救複囌成功,後經病理及肺血管造影證實氣管黏膜血管異常,攷慮支氣管Dieulafoy病,行栓塞治療後好轉.結論 支氣管Dieulafoy病文獻報道較少,髮病原因不詳,可能與支氣管肺動脈先天髮育異常和(或)後天的慢性炎癥刺激、損傷有關,文獻報道少可能與認識不足有關.遇有不明原因大咯血需行氣管鏡檢查時,氣管鏡檢查髮現氣管黏膜呈"蚯蚓"樣突起,應想到該病的可能,不要盲目活檢,應想到有大咯血窒息可能,如確需活檢,應備好搶救措施.
목적 탐토지기관Dieulafoy병림상표현、진단급치료방법.방법 결합아원수치적1례지기관Dieulafoy병적림상자료급국내외문헌보도적병례진행종합분석.결과 환자남성,70세,반복간단각혈30년,대각혈8 h주원,흉부평편급CT미발현이상,행지기관검사발현기관점막정"구인"양돌기,활검과정중돌연출현대출혈질식,경창구복소성공,후경병리급폐혈관조영증실기관점막혈관이상,고필지기관Dieulafoy병,행전새치료후호전.결론 지기관Dieulafoy병문헌보도교소,발병원인불상,가능여지기관폐동맥선천발육이상화(혹)후천적만성염증자격、손상유관,문헌보도소가능여인식불족유관.우유불명원인대각혈수행기관경검사시,기관경검사발현기관점막정"구인"양돌기,응상도해병적가능,불요맹목활검,응상도유대각혈질식가능,여학수활검,응비호창구조시.
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.
