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近几年由于纤支镜及CT扫描技术的发展和应用,使支气管结石症的早期诊断成为可能,致本症的报告有增多的趋势,兹将我院的2例报告如下.病历摘要例1,男,53岁.因反复咯血8个月入院,每次咯血量10至数百毫升,在本地抗结核治疗半年余效果不佳.胸片录右上肺叶尖后段片状密度不均匀之阴影,伴有斑点状钙化.纤支镜检示右上肺支气管粘膜充血,外压性狭窄.胸部CT扫描显示肺门、纵隔淋巴结多个大钙化影和病变内侧的钙化,压迫并侵犯右上叶支气管.1月后患者咯出一小黄豆大小结石后咯血逐渐停止.诊断:肺结核并支气管结石症.例2,男,58岁.因畏寒发热1个月入院,胸片示左上肺片状密度较淡阴影,断层片见病变为不规则块影,伴有分叶毛刺.胸部CT除证实左上肺4.7cm×3.0cm大小形状不规则块影外,还发现病变内侧小点状钙化.经大剂量抗生素和正规抗结核治疗近3个月,患者仍间断发热,左上肺病变吸收延缓、消散不全时有发展,疑为肺癌而行手术,术后病理证实为左上肺炎性假瘤,肺门淋巴结炎,左上叶支气管内0.2cm×0.3cm×0.1cm大小结石,故诊断为支气管结石症并阻塞性肺炎,炎性假瘤形成.
In recent years due to the development and application of bronchoscopy and CT scanning technology, the early diagnosis of bronchial stone disease possible, the report of this disease have an increasing trend, we will report 2 cases of hospital as follows. , Male, aged 53. Due to repeated admission of 8 months of hemoptysis, each hemoptysis 10 to several hundred milliliters in the local anti-TB treatment for more than six months ineffective chest radiographs of the posterior segment of the posterior segment of the lobular density uneven shadow , With speckled calcification, bronchoscopy showed right upper lung bronchial mucosal hyperemia, external pressure stenosis.Chest CT scan showed multiple calcification of the hilar and mediastinal lymph nodes and medial calcification of the lesion, oppression and violation of the right upper lobe bronchus. In January, the patient gave up a small amount of soybeans after the size of the stone hemoptysis gradually stopped. Diagnosis: tuberculosis and bronchial stone disease .Example 2, male, 58 years old .For chills and fever for 1 month hospitalization, chest radiograph showed left upper lung flake density Light shadow, the lesions of the film to see the irregular block, accompanied by leaflet burr.Chest chest CT in addition to confirmed the shape of the upper left lung 4.7cm × 3.0cm irregular shape of the block, also found small lesion calcification within the large dose Antibiotics and regular anti-TB treatment for nearly 3 months, patients still between Fever, upper left lung lesions absorption delay, when the disappearance of the development of suspected lung cancer surgery, postoperative pathology confirmed as left upper lung pseudotumor, hilar lymphadenitis, left upper lobe bronchi 0.2cm × 0.3cm × 0.1cm size Stones, it is diagnosed as bronchial stone disease and obstructive pneumonia, inflammatory pseudotumor formation.