CAJ | 학술논문

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.
목적 탐토지기관경대골화성기관지기관병적진치개치,제고대해병적인식.방법 대중남대학상아의원호흡과지기관경실2006년6월지2007년7월수치적10례골화성기관지기관병환자적림상증상、지기관경하표현、조직병리결과 급지기관경하치료경과화료효진행회고성연구.결과 10례중남8례,녀2례,년령33～76세,평균(46 ±16)세.지기관경하가견대소불일적결절철향관강,연기관、지기관종향분포,주요루적기관화주지기관,협、단지기관교소루적;7례결절국한우기도전측벽,3례동시루급후측벽.안결절분포밀도장기분위3형:분산형、미만형화융합형,분별위3례、5례화2례.6례접수치료적환자중2례선용등리자사빈치료,4례선용아기도치료.술중급술후균미출현엄중병발증.치료후환자기도내결절교치료전감소,림상증상개선.결론 골화성기관지기관병역오진、루진;지기관경연합조직병리검사시학진적최가수단;지기관경하등리자사빈화아기도치료시유효적고식치료수단.
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 - 76years). The bronchoscopic appearance of TO was rouhiple 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 eases. Six patients received bronchoseopie management, including radiofrequency treatment for 2 patients and argon ion laser treatment for the other 4. 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 roethod for the diagnosis of TO. Radiofrequency and argon ion laser treatment are safe and effective.