支气管内型错构瘤的诊断及治疗

Diagnosis and Treatment of Endobronchial Harmatoma

４例支气管内错构瘤占同期肺错构瘤的９．５％（４／４２）。管内型与肺内型错构瘤是病理形态上相同而发生部位不同的一类肿瘤。前者发生在较大的支气管内，引起肺内继发改变，后者发生在细小支气管内，表现为肺内孤立、边缘清晰、密度增高的肿物。管内型错构瘤术前较难确诊，易与中心型肺癌混淆。手术系本病治疗方法，因疾病过程有反复炎症，肺门淋巴结与血管形成紧密粘连，术中需仔细操作以防止血管损伤。

Four patients with endobronchial hamartoma were operated upon from 1983.7 to 1992.6.The incidence rate was 9.5% (4/2).The endobronchial and intrapulmonary hamartoma have similar pathological features.However,the former occurs in the larger bronchus and often leads to obstructive pulmonary infection.The latter occurs in the very small bronchus and manifests itself as solitary,sharply outlined round tumor in the chest film.It is difficult to diagnose accurately the endobronchial hamartoma before operation,and it is usually misdiagnosed as lung cancer.The operative resection is the first choice.If the tumor is located in the main bronchus,removal of hamartoma through the bronchotomy is preferable to pneumonectomy.If the tumor is located in the lobular or segmental bronchus,lobectomy or segmentectomy should be performed.Owing to the presence of dense adhesion between the inflammatory lymph node and pulmonary vessels,meticulous dissection should be achieved in order to avoid inadvertent bleeding.