累及气道的复发性多软骨炎20例临床分析  

Recurrent polychondritis involving airway:Clinical Analysis of 20 patients

作　　者：薛新颖[1] 王娜[1] 薛庆亮[1] 张丽娜[1] 郭丽娜[1] 汪建新[1] 

机构地区：[1]解放军总医院呼吸科,北京100853

出　　处：《军医进修学院学报》2011年第12期1217-1219,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探讨累及气道的复发性多软骨炎的诊断和治疗方法。方法回顾性分析我院1998年-2010年20例累及气道的复发性多软骨炎临床资料。结果 20例气道受累,占45.45%(20/44),其中男性10例,女性10例,年龄20-72岁,平均42.25岁。临床主要表现咳嗽、咳痰、胸闷、气短及声嘶等,严重时可出现呼吸困难。胸部CT主要表现为气道壁局限性或弥漫性增厚伴管腔狭窄,部分患者出现软骨钙化,严重者可出现气道塌陷、管腔明显狭窄、肺部感染和肺不张。支气管镜可见气道黏膜充血、水肿、增厚及软骨环模糊,严重者出现软骨环消失、气道塌陷和管腔显著狭窄。治疗包括糖皮质激素、抗炎、免疫抑制剂等,治疗后除2例因严重感染和呼吸衰竭死亡外,余18例病情均得到控制。结论累及气道的复发性多软骨炎临床表现多样,极易误诊,诊断主要依据临床表现、胸部CT和支气管镜及肺功能检查,早期应用糖皮质激素等药物综合治疗可明显改善临床症状和预后。Objective To study the diagnostic and therapeutic methods of recurrent polychondritis（RP） involving airway.Methods Clinical data about 20 patients with RP involving airway admitted to our hospital from 1998 to 2010 were retrospectively analyzed.Results The airway was involved in 20 RP patients,accounting for 45.45%（20/44）.Of the 20 patients,10 were males and 10 were females with a mean age of 42.25 years（range 20-72 years）.The main clinical manifestations were cough,expectoration,chest tightness,shortness of breath,hoarseness and dyspnea.Abnormal chest CT findings included local and diffuse airway wall thickening,airway stenosis and airway wall calcification.Airway collapse,severe airway stenosis,pulmonary infection and atelectasis were usually found in severe patients.Abnormal bronchoscopy showed mucomembranous hyperemia,edema,thickening and unclear cartilaginous ring.Disappeared cartilaginous ring,airway collapse and obvious airway stenosis were identified in severe patients.Therapeutic agents used were corticosteroids,anti-inflammatory drugs,immunosuppressive agents,etc.After treatment,18（90%） patients recovered and 2 died.Conclusion RP involving airway has a variety of clinical manifestations and is easy to be misdiagnosed.The diagnosis of RP mainly depends on its clinical manifestations,chest CT findings,bronchoscopic findings and lung function tests.Early use of corticosteroids can significantly improve its clinical symptoms and prognosis.

关 键 词：多软骨炎 复发性 气道阻塞 诊断 治疗 

分 类 号：R593.9[医药卫生—内科学]