Miyazaki Hiroo, Shimane Shoko, Morita Sumihito, Yamada Takashi, Ida Masaaki, Ozawa Yoshihiro, Nagayama Masaharu, Iwakiri Shotaro, Chihara Koji, Hirata Takeo
Department of Respiratory Medicine, Shizuoka City Hospital.
Nihon Kokyuki Gakkai Zasshi. 2005 May;43(5):328-32.
A 59-year-old man, who had been treated for bronchial asthma since 2000, was hospitalized with high fever and productive cough in November 2003. Chest radiography on admission showed consolidations in both lower lung fields, and computed tomography demonstrated anteroposterior narrowing of both main bronchi. A physical examination revealed deformity of auricular cartilage and saddle nose, and we diagnosed him relapsing polychondritis (RP). When he was readmitted 4 months later because of severe tracheobronchial stenosis and respiratory failure he required mechanical ventilation, but it was difficult to wean him from the ventilator. Self-expandable metallic stents were placed in the left main bronchus and the trachea. After the procedure, he was successfully weared from mechanical ventilation. Since airway complications of RP can be fatal, stent implantation should be considered in the management of RP with airway manifestations.
一名59岁男性,自2000年起接受支气管哮喘治疗,于2003年11月因高热和咳痰入院。入院时胸部X线检查显示双下肺野实变,计算机断层扫描显示双侧主支气管前后径变窄。体格检查发现耳廓软骨畸形和鞍鼻,我们诊断他为复发性多软骨炎(RP)。4个月后,他因严重气管支气管狭窄和呼吸衰竭再次入院,需要机械通气,但难以撤机。在左主支气管和气管置入了自膨式金属支架。术后,他成功撤机。由于RP的气道并发症可能致命,对于有气道表现的RP患者,在治疗中应考虑支架植入。