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[骨软骨成形性气管支气管病]

[Osteochondroplastic tracheobronchopathy].

作者信息

Grünling S, Rosenhagen K, Ullrich W

机构信息

Klinik für Anästhesiologie und operative Intensivmedizin, Diakonie-Krankenhaus Schwäbisch Hall, Akademisches Lehrkrankenhaus der Universität Heidelberg.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2001 Feb;36(2):110-4. doi: 10.1055/s-2001-11053.

Abstract

The words tracheobronchopathia osteochondroplastica (TO) were coined by Aschoff in 1910, defining a rare disease of the tracheobronchial system which most often is only "accidentally" discovered in the course of examinations, a bronchoscopy or computerized tomography, which are undertaken for other reasons. A characteristic sign for this disease are multiple cobblestone-like protrusions in the trachea and bronchus which are caused by calcifications, chondrifications and ossifications of the upper layer of the mucous membrane. We report on a 81-year old patient who was diagnosed with the disease while undergoing a fiberoptic bronchoscopy during a prolonged weaning phase. In the beginning we discussed the possibility of a neoplasia or a chronic inflammatory process as differential diagnosis and based on that we considered a dilatative tracheotomy for the weaning period. After histological confirmation of a TO we refrained from the measure, the reason being that in our opinion the patient would not profit from it. To reach a correct diagnosis a good interdisciplinarian cooperation is essential. The patient was successfully extubated on the 11th post-operative day after a patient conventional weaning which was supported by accompanying symptomatic measures. Apart from the case report we present a summary of the literature on TO concerning epidemiology, pathology, diagnosis and therapeutical measures.

摘要

气管支气管骨软骨化生(TO)这一术语由阿绍夫于1910年提出,它定义了一种气管支气管系统的罕见疾病,这种疾病大多仅在因其他原因进行的检查(如支气管镜检查或计算机断层扫描)过程中“偶然”被发现。该疾病的一个特征性表现是气管和支气管内出现多个鹅卵石样突起,这些突起是由黏膜上层的钙化、软骨化和骨化引起的。我们报告了一名81岁的患者,该患者在长期撤机阶段接受纤维支气管镜检查时被诊断出患有此病。一开始,我们讨论了肿瘤或慢性炎症过程作为鉴别诊断的可能性,并在此基础上考虑在撤机期间进行扩张性气管切开术。在组织学确诊为TO后,我们放弃了该措施,原因是我们认为患者不会从中受益。要做出正确诊断,良好的多学科合作至关重要。在采取了相应对症措施辅助的常规撤机后,患者于术后第11天成功拔管。除了病例报告外,我们还对有关TO的流行病学、病理学、诊断和治疗措施的文献进行了总结。

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