支气管镜下高频电凝圈套加高频电凝治疗支气管脂肪瘤1例报道并文献复习  

High frequency electric coagulation snare and high frequency electric coagulation in treatment of endobronchial lipoma：a case report and literature review

作　　者：徐琴[1] 吴峰[1] 欧阳小平[1] 黄华[1] 

机构地区：[1]扬州市第一人民医院呼吸科,225001

出　　处：《国际呼吸杂志》2016年第22期1710-1713,共4页International Journal of Respiration

摘　　要：目的 了解支气管脂肪瘤的临床特征,提高对该病的认识。方法 分析我科收治的 1例经病理证实为支气管脂肪瘤患者的资料,并回顾性复习国内外相关的文献。结果 患者男, 78 岁,表现为阻塞性肺炎伴咯血,胸部 CT 及三维重建提示脂肪瘤可能 （ CT 值为 -100^-21Hu ）,在全身麻醉下行支气管镜下高频电凝圈套加高频电凝切除术,术后支气管通畅,病理证实为脂肪瘤。结论支气管脂肪瘤为罕见的良性肿瘤,临床症状、体征无特异性,常表现为哮喘、阻塞性肺炎、 COPD 、肺癌等,误诊率达 55.0% ,确诊时间为 11 个月。诊断主要依靠胸部 CT 及三维重建和核磁共振成像,病理为确诊依据。治疗方法有外科手术和内镜下切除,切除的方法取决于肿瘤的大小和肺损伤的程度。镜下治疗支气管脂肪瘤是一项安全、有效、经济的治疗手段。Objective To learn the clinical features of bronchial lipoma and to promote the cognition of this disease. Methods The data of one patient with bronchial lipoma pathologically proved were analysed. The domestic and foreign literatures related to bronchial lipoma were reviewed. Results The male patient was 78 years old, whose clinical symptom was obstructive pneumonia with hemoptysis, chest CT and Lhree-dimensional reconstruction were suggestive of lipoma （CT value：- 100-21 Hu）. Under general anesthesia, after high frequency electric coagulation snare and high frequency electric coagulation by bronchosecope, his airway was unobstructed. Pathological examination was lipoma. Conclusions Bronchial lipoma is a rare benign tumor. Clinical symptoms and signs are not specific. Because its common symptoms are similar to asthma, obstructive pneumonia, chronic obstructive pulmonary disease and lung cancer, misdiagnosis rate is 55.0%. It takes 11 months from onset to confirmed diagnosis. The diagnosis is mainly depended on chest CT, three-dimensional reconstruction and MRI. The pathological diagnosis is golden standard. The excision methods are decided by the size of the tumor and the degree of lung damage. Endoscopic treatment of bronchial lipoma is a safe, effective and economic treatment.

关 键 词：支气管脂肪瘤 支气管镜 高频电凝圈套 高频电凝 

分 类 号：R734.1[医药卫生—肿瘤]