摘要
目的 探讨骨化性气管支气管病 (TO)的临床特征、诊断和治疗。方法 对TO患者行影像学、肺功能、支气管镜及病理学检查并结合文献分析其临床特点。结果 TO是指气管粘膜下有多发性骨质和软骨组织结节状增生并突向管腔。 1999年 6月～ 2 0 0 0年 5月经纤维支气管镜检查 (纤支镜检 )TO的阳性率为 0 3 5 % ( 4 /112 5 ) ,2男 2女 ,3 5～ 60岁 ,既往行纤支镜检及活检均误诊。TO症状为咳嗽 ( 3 /4)、咳痰 ( 2 /4)、血丝痰 ( 3 /4)、声嘶 ( 1/4)等 ,亦可无症状 ( 1/4) ,胸片均未见异常。CT示气管壁有不规则斑点状钙化影并突入管腔 ( 3 /4)。 1例呈轻度阻塞性通气功能障碍 ,其余 3例气道阻力测定有 1例增加。纤支镜检气管壁可见特征性的大小不等结节突向管腔 ,质硬。病理均见粘膜下软骨和骨质结节状增生。 1例给予丙酸倍氯米松和茶碱治疗 ,半年后症状、气管粘膜充血改善。结论 TO不是罕见病 ,易被漏诊、误诊 。
Objective To describe the clinical manifestations of tracheobronchopathia osteochondroplastica (TO). Methods X ray film, CT scanning, lung function, fibro bronchoscopy and histological examination were performed in all 4 patients Clinical features were analyzed with reviewing the reported literatures. Results From June 1999 to May 2000, 4 cases of TO (male/female: 2/2, age: 35～60 yrs) were found among the 1 125 cases of fibro bronchoscopy, with the positive rate of 0 35% TO was characterized by cartilaginous and /or osseous submucosal nodules in the trachea and the central bronchi Symptoms included cough (3/4), hemoptysis(2/4), hoarseness (1/4), with one case of entirely symptom free Radiography showed no use for the diagnosis Multiple submucosal nodules and plaques that outgrew into the lumen of the trachea were revealed by CT scanning in 3 of 4 cases Pulmonary function testing showed normal in 3 patients and mild obstruction in 1 patient The bronchoscopic appearance of TO presented with multiple whitish, hard nodules projecting into the tracheal lumen from anterior and lateral walls , with sparing of the posterior wall Pathological examination showed island of bony tissue and cartilage in the submucosa with almost intact respiratory epithelium The symptoms and mucosal hyperemia were improved in one patient treated with beclomethasone dipropionate and theophylline for 6 months Conclusions As an uncommon disease, TO is often misdiagnosed or underdiagnosed Fibro bronchoscopy and CT scan remain the main methods for the diagnosis of TO
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2001年第7期414-416,I004,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
骨化性气管支气管病
支气管镜检查
CT
诊断
治疗
Tracheobronchopathia osteochondroplastica
Bronchoscopy
Tomography,X-ray computed
