摘要
目的对支气管结石的内镜下介入治疗方法进行总结,以期为其诊治提供临床思路。方法收集2021年12月至2024年12月我院收治的11例支气管结石患者的临床资料、支气管镜下治疗方法和结果进行回顾性分析。结果纳入研究的11例患者的平均年龄为(59.9±15.9)岁,最常见的症状是咳嗽(34.5%)和咳痰(24.1%),其次是呼吸困难(17.2%)、发热(10.3%)及咯血(6.9%),仅1例患者出现咯石。结核分支杆菌复合群感染为最常见的病原体,其次为真菌感染和铜绿假单胞菌感染。支气管结石最常见的并发症为肺不张(47.4%),其次是阻塞性肺炎(42.1%)和支气管扩张(10.5%),所有11例支气管结石的患者均通过支气管镜将支气管腔内结石取出,部分遗留余管壁的支气管结石。6例患者经过活检钳或异物钳取出,3例联合冷冻治疗冻取、2例联合激光碎石、硬质支气管镜异物钳夹碎取出。所有患者均给与经验性抗感染治疗,8例患者取石复查胸部CT提示肺部病灶均有好转。结论支气管结石是支气管内良性病变,主要为慢性感染所致,尤其是结核感染,支气管结石会引起阻塞性肺炎、支气管扩张等严重并发症,支气管结石首选经支气管镜取石治疗,可联合采用多种手段取石治疗,支气管结石取石后抗感染治疗对症状缓解具有重要作用。
Objective To summarize the endoscopic interventional treatment methods of broncholithiasis for providing clinical strategies for its diagnosis and treatment.Methods The clinical characteristics,bronchoscopic interventional therapy and outcomes of 11 patients with broncholithiasis admitted to our hospital from December 2021 to December 2024 were retrospectively reviewed.Results The average age of the 11 patients included in the study was(59.9±15.9)years,and the most common symptoms were cough(34.5%)and sputum(24.1%),followed by dyspnea(17.2%),fever(10.3%)and hemoptysis(6.9%).Only 1 patient developed pyrolithiasis.Mycobacterium tuberculosis complex group infection was the most common pathogen,followed by fungal infection and pseudomonas aeruginosa infection.The most common complication of bronchial calculi was atelectasis(47.4%),followed by obstructive pneumonia(42.1%)and bronchiectasis(10.5%).All 11 patients with bronchial calculi were totally removed by bronchoscopy,a few left partial residual bronchial stone.6 patients were removed by biopsy forceps or foreign body forceps,3 patients were removed by cryotherapy,and 2 patients were removed by laser lithotripsy combined with hard bronchoscopic foreign body forceps.All patients were given empirical anti-infective therapy,and 8 patients underwent stone removal and chest CT examination,indicating that the lung lesions were improved.Conclusion Broncholithiasis are benign intrabronchial lesions,mainly caused by chronic infection,especially tuberculosis infection.Bronchial calculi can cause serious complications such as obstructive pneumonia and bronchiectasis.Bronchoscopic lithotomy is the first choice for bronchial calculi treatment,which can be combined with various means of lithotomy.Anti-infective treatment after bronchial calculus removal plays an important role in symptom relief.
作者
张梦
康亮
郑婷
程文涛
周霞
沈力
陈慧冬
ZHANG Meng;KANG Liang;ZHENG Ting;CHENG Wentao;ZHOU Xia;SHEN Li;CHEN Huidong(Department of Respiratory Intervention,Wuhan Jinyintan Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei 430023,China;Hubei Clinical Research Center for Infectious Diseases,Wuhan,Hubei 430023,China;Wuhan Research Center for Communicable Disease Diagnosis and Treatment,Chinese Academy of Medical Sciences,Wuhan,Hubei 430023,China;Joint Laboratory of Infectious Diseases and Health,Wuhan Institute of Virology and Wuhan Jinyintan Hospital,Chinese Academy of Sciences,Wuhan,Hubei 430023,China)
出处
《临床肺科杂志》
2026年第1期53-59,共7页
Journal of Clinical Pulmonary Medicine
基金
武汉市卫生计生委科研计划资助项目(WX18Q38)
武汉市科技局知识创新专项项目(202302020102568)
武汉市卫健委系统青年人才资助“晨星”计划资助项目。
关键词
支气管结石
支气管镜
介入治疗
broncholithiasis
bronchoscopy
interventional therapy
