摘要
目的探讨多层螺旋CT联合支气管镜对老年患者支气管异物的诊治价值。方法回顾性分析28例老年患者支气管异物的临床表现、肺部CT影像表现、支气管镜下特征及治疗方法。结果主要临床表现为发热、咳嗽、咳脓痰、喘鸣、胸闷、咯血。常误诊为肺炎、肺癌、肺结核、支气管扩张等疾病，误诊时间1m～5年。17例肺部多层螺旋CT检查可见异物的直接表现，28例均经支气管镜成功钳出异物。23例镜下直接见到异物，2例异物被肉芽组织包埋，3例吸净脓性分泌物夹除脓苔后见到异物，3例经第2次气管镜检查取出异物，1例异物合并支气管肺癌。结论联合多层螺旋CT及支气管镜检查有助于老年患者支气管异物的诊治。
Objective To investigate the clinical value of multi-slice spiral computed tomography （CT） combined with bronchoscopy in diagnosis and treatment of bronchial foreign body in elderly patients. Methods The clinical manifes- tation, imaging findings of chest CT, characteristics under bronchoscopy and treatment of 28 cases of bronchial foreign body in elderly patients were analyzed retrospectively. Results The major clinical manifestations were fever, cough, purulent sputum, wheezing, chest tightness, and hemoptysis. It is quite often clinically misdiagnosed as pneumonia, lung cancer, tuberculosis, bronchiectasis, et al, with the misdiagnosis period from 1 month to 5 years. 17 cases showed imaging findings of foreign body in pulmonary multi-slice spiral CT; 23 cases of foreign bodies can be seen directly under the bronchoscopy; 2 cases of foreign bodies were surrounded by the granulation tissue; 3 cases of foreign bodies were covered by purulent exudate and can be seen after removing the pus moss. The foreign bodies were taken out successfully under the bronchoscopy in all the 28 cases, including 3 cases removed by repeated bronchoscopy. Conclusions Combining multi-slice spiral CT and bronchoscopy is helpful to diagnose and to cure bronchial foreign body in elderly patients.
出处
《老年医学与保健》
CAS
2013年第6期367-369,共3页
Geriatrics & Health Care
关键词
多层螺旋CT
支气管镜
老年
支气管异物
诊断
治疗
Multi-slicespiralCT
Bronchoscopy
Elderly
Bronchial foreignbody
Diagnosis
Treatment
