Jin Yu-Xing, Jiang Ge-Ning, Jiang Lei, Ding Jia-An
Department of Thoracic Surgery, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai, China.
Thorac Cardiovasc Surg. 2016 Aug;64(5):450-5. doi: 10.1055/s-0034-1395388. Epub 2014 Dec 2.
Background Broncholithiasis is a rare disease with various clinical classifications. The aim of this study was to evaluate the imaging diagnosis and surgical treatment of broncholithiasis. Methods and Materials Forty-eight patients with broncholithiasis were enrolled in this retrospective study between January 1985 and December 2009. Patients were classified into intraluminal, transluminal, and extraluminal broncholith according to the anatomy between the calculus and the bronchial lumen confirmed by chest computed tomography (CT), bronchoscopy, and pathology after operation. Result Forty-eight patients were enrolled, with 33 males and 15 females. The sex ratio (male:female) was 2.2:1, and average age was 54.3 ± 13.6 years. There were 8, 19, and 21 patients in intraluminal, transluminal, and extraluminal broncholith group, respectively. Cough, hemoptysis, and chest pain were the most common symptoms. Four patients with intraluminal broncholith and two with transluminal broncholith underwent broncholith removal via bronchoscopy, and the other 42 patients underwent thoracotomy. Conclusion Bronchoscopy combined with CT examination is helpful in diagnosing and typing broncholithiasis. An optimal treatment method, either bronchoscopic removal of broncholithiasis or thoracotomy, according to the clinical typing and indications, is the key to improve the treatment effect.
背景 支气管结石症是一种临床分类多样的罕见疾病。本研究旨在评估支气管结石症的影像学诊断及外科治疗。方法与材料 1985年1月至2009年12月期间,48例支气管结石症患者纳入本回顾性研究。根据胸部计算机断层扫描(CT)、支气管镜检查及术后病理证实的结石与支气管腔之间的解剖关系,将患者分为腔内型、跨壁型和腔外型支气管结石。结果 共纳入48例患者,男性33例,女性15例。男女比例为2.2∶1,平均年龄为54.3±13.6岁。腔内型、跨壁型和腔外型支气管结石组分别有8例、19例和21例患者。咳嗽、咯血和胸痛是最常见的症状。4例腔内型支气管结石患者和2例跨壁型支气管结石患者通过支气管镜进行了结石清除,其余42例患者接受了开胸手术。结论 支气管镜检查联合CT检查有助于支气管结石症的诊断和分型。根据临床分型及适应证选择最佳治疗方法,即支气管镜下清除支气管结石或开胸手术,是提高治疗效果的关键。