摘要目的 提高临床医师对支气管结石症的认识;评价可弯曲支气管镜在支气管结石症治疗中的价值.方法 对第二军医大学附属长海医院及浙江省台州市医院2000年1月至2007年5月临床确诊支气管结石症的31例患者的临床资料、影像学特征、支气管镜下表现、疗效及并发症进行回顾性分析.结果 31例患者中男19例,女12例,平均年龄(58.6±12.6)岁.临床漏诊26例(26/31),误诊19例(19/31);所有患者通过胸部CT联合支气管镜检查确诊.共诊断36枚支气管结石,其中腔内型26枚,透壁型9枚,管外型1枚.对其中26例的31枚结石进行了可弯曲支气管镜下取石治疗,成功取出25枚支气管结石,摘除腔内型结石23枚(23/25).1例患者术后咯血300 ml,其他患者未发生明显的并发症.结论 支气管结石症易漏诊、误诊;胸部CT联合支气管镜检查是诊断支气管结石症的有效方法;可弯曲支气管镜下治疗支气管结石症安全有效,尤其适用于腔内型结石的治疗.

abstractsObjective To report the diagnostic experience for broncholithiasis,and to evaluate the value of flexible bronchoscopic management for the disease. Methods The clinical data, radiological features,bronchoscopy findings,the effect and complications of bronchoscopic management in 31 patients with broncholithiasis admitted to changhai hospital of second military medical university and zhejiang Taizhou Hospital between 2000 and 2007 were retrospectively reviewed. Results There were 19 men and 12 women, the mean age was 58.6±12.6. There were 26 cases missed diagnosis, and 19 cases were misdiagnosis. The diagnosis was confirmed by chest CT combined with bronchoscopy in all the patients.Thirty-six broncholiths were revealed,of which 26 were intraluminal,9 eroding in the bronchial wall, and 1 peribronehial. In 26 patients,31 broncholiths were managed by flexible bronchoscope,and 25 broncholiths were successfully removed. The success rate for intraluminal free broncholiths was higher(23/25). One patient experienced hemoptysis of 300 ml after therapy,but no significant complications occurred in other patients. Conclusions The diagnosis of broncholithiasis can be easily missed or misdiagnosed. Chest CT combined with bronchoscopy were useful methods for the diagnosis of the disease. Extraction of broncholiths with flexible bronchoscope iS a safe and effective management, especially for intraluminal broncholiths.