气管支气管黏膜角化症的临床分析  

Clinical Analysis of Tracheobronchial Mucosa Keratosis

作　　者：韩建芳[1] 胡锦兴[1] 彭德虎[1] 周薇 HAN Jian-fang;HU Jin-xing;PENG De-hu(The Eighth Internal Medicine Department,Guangzhou Chest Hospital,Guangzhou,510095,China)

机构地区：[1]广州市胸科医院内八科,广州510095

出　　处：《黑龙江医学》2020年第11期1485-1489,共5页Heilongjiang Medical Journal

基　　金：广东省自然科学基金项目(2016A030310107)。

摘　　要：目的探讨气管支气管黏膜角化症的临床特征、诊断、治疗及预后,提高对该病的认知。方法报道广州市胸科医院1例气管支气管黏膜角化症患者的临床资料,结合文献已报道的15例气管支气管黏膜角化症患者的资料,总结气管支气管黏膜角化症的临床特征、影像学、支气管镜下表现、细菌学检测、组织病理结果、治疗及预后。结果16例中有7例治疗史不详,剩余9例中1例因经济原因拒绝治疗外,余均予治疗;治疗方案有抗感染、对症治疗,还有高频电刀切除角化黏膜治疗、激素、复合维生素、中医治疗等。有7例治疗病人完成随访,症状均有好转;3例复查支气管镜示镜下表现无改变,1例予抗感染、对症及高频电刀切除角化黏膜治疗的患者4月后复查支气管黏膜恢复正常,1例予抗感染、对症治疗的患者复查气管镜示黏膜白斑较前减少;随访病人均未见癌变。未治疗病例随访发现患者症状仍反复。结论气管支气管黏膜角化症主要发生在气管支气管,向上可累及咽喉部;临床症状及影像学表现多样;支气管镜检查提示,气管黏膜在不同的发病阶段可表现为黏膜充血型、黏膜颗粒型及黏膜颗粒融合型;病理检查可确诊,可能为良性病变,但有发生恶变的倾向;该病暂无特异性治疗方法,抗感染治疗可以改善症状,减轻角化;激素治疗无效。Objective To explore the clinical features,diagnosis,treatment and prognosis of tracheobronchial mucosa keratosis and improve the cognition of the disease.Methods One case of tracheobronchial mucosa keratosis in the hospital was reported through combining with cases of tracheobronchial mucosa keratosis having been reported in literature to analyze the clinical features,imaging,bronchoscopy,bacteriology,histopathology,treatment and prognosis.Results A total of 16 pathologically confirmed cases of tracheobronchial mucosal keratosis were included,including 7 cases with not clear treatment history and 1 case with the rejection of treatment because of economic reasons.Therapeutic schedule included anti-infection,expectant treatment,high frequency electricity leep excision of cutinization mucosa,hormone,devavitamin and traditional Chinese medicine treatement.7 patients were followed up,and the symptoms recovered.3 patients had no change under review bronchoscope.1 patient with anti-infection and high frequency electricity leep excision of cutinization mucosa had recovered.1 case received anti-infection and had less vitiligo mucosa after review bronchoscope.There was no cancer patient during follow-up.The symptoms of untreated patients appeared.Conclusion Tracheobronchial mucosa keratosis mainly occurs in the trachea and bronchus,and can affect the throat upwards.Clinical symptoms and radiographic features are various.Bronchoscopy shows that Tracheobronchial mucosa keratosis in different stages can be manifested as mucosal congestion,mucosal granules and mucosal granules fusion type.Pathological examination can diagnose the disease,while the pathology shows tracheobronchial mucosa keratosis has the tendency of malignant transformation.No specific treatment method is specified for the disease.Anti-infective treatment can improve symptoms,reduce the mucosal keratinization.Glucocorticoid therapy is ineffective.

关 键 词：气管 支气管 黏膜角化 支气管镜 病理 预后 

分 类 号：R562[医药卫生—呼吸系统]