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支气管结石

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概述编辑本段回目录

     支气管结石指位于支气管腔内或侵蚀到腔内的钙化团块可引起严重的支气管刺激和阻塞症状。

医学百科网-MedBaike. com


医学百科网-MedBaike. com

支气管结石支气管结石

医学百科网-MedBaike. com


医学百科网-MedBaike. com

病因编辑本段回目录

形成结石的原因有: 医学百科网-MedBaike. com

1.异物吸引或感染分泌物构成结石的核心,外被钙盐沉积而逐步形成结石。 医学百科网-MedBaike. com

2.肺门淋巴结钙化或肺内钙化灶侵蚀支气管并进入支气管腔内形成,临床最多见。

医学百科网-MedBaike. com

3.支气管软骨脱落后进入支气管腔内形成。

医学百科网-MedBaike. com

临床表现编辑本段回目录

     虽然仅很少数病人会咳出结石,但多数支气管结石病人有症状,是由于结石对支气管黏膜的机械刺激和结石对支气管梗阻引起。最常见症状是迁延性严重的咳嗽, 通常持续数年,常用治疗不能缓解,如果有肺部感染健康,会伴有大量脓痰,咯血是由于病变直接侵蚀血管,或侵蚀支气管受侵部位形成的肉芽组织所致,不像支气管扩张所见的那样咯血罕见致命。支气管结石阻塞后可闻及喘鸣音另可有慢性咳脓痰,严重可引起阻塞性肺炎、肺不张、继发支气管扩张。 医学百科网-MedBaike. com

检查编辑本段回目录

1、X线胸片 支气管结石显示肺门增大、多部位钙化、伴远端肺不张或间质实变。与以往胸片对照可见钙化点移位。
2、CT 有助于结石的显示,并能准确地确定钙化灶位于支气管内,也可见到梗阻远端的扩张支气管和阻塞性肺炎、肺不张等。 医学百科网-MedBaike. com
3、支气管镜检查 可显示支气管结石本身、肉芽肿组织或支气管狭窄;也可鉴别支气管肿瘤引起的钙化。 医学百科网-MedBaike. com

影像学表现编辑本段回目录

      肺门有钙化的淋巴结阴影。钙化的位置和数目在不同时间照片上可有变化。结石阻塞支气管后可发生阻塞性肺炎或肺不张。相应的肺组织内有斑片状阴影,体积缩小。结石阻塞的支气管远端发生支气管粘液栓塞后形成柱状、“V”型或“Y”型致密阴影。 医学百科网-MedBaike. com

治疗编辑本段回目录

 1.支气管镜取石, 在并发症出现之前应采用内镜取石。Cole等建议取出结石时,要避免暴力或撕拉,支气管灌洗有助于将结石与支气管壁分开。正如Faber所提出的,目前的治疗方案是开胸手术,实际上Faber等建议非手术治疗的病人仅限于“病人已咳出支气管结石或内镜已取出结石者”,如果暴力或撕拉邻近肺血管或食管的结石,在取出过程中可能发生意外。 医学百科网-MedBaike. com

2.手术的适应证 包括并发支气管扩张、慢性阻塞性肺炎、反复咯血和远端产生脓痰的支气管狭窄。术中尽量保留正常肺组织,但最大限度去除支气管结石和远端支气管扩张,手术病例中分离血管可能发生意外,最好在分离远端以前满意地控制肺动脉。

医学百科网-MedBaike. com

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