76例上气道阻塞临床分析

Clinical analysis of 76 cases with upper airway obstruction

目的探讨上气道阻塞的认识和早期诊断。方法回顾分析2004年1月～2007年4月确诊为上气道阻塞的76例病例的临床及病理学特点。结果本组患者呼吸道淀粉样变19例;复发性多软骨炎23例;肿瘤25例,结核8例;临床表现为咳嗽46例;呼吸困难36例;声嘶43例、咯痰29例;肺功能检查56例,其中27例(48.21%)表现为阻塞性通气功能障碍,14例(25%)表现为混合性通气功能障碍;有70例纤维支气管镜或喉镜检查,有明显阳性发现者67例,约占95.71%,其中气管、支气管壁增厚和/或狭窄者35例,占50%;异常气管内结节或新生物32例,占45.71%;76例中60例进行病理学检查:刚果红染色阳性者16例;符合复发性多软骨炎5例;肿瘤25例;支气管黏膜慢性炎10例。讨论肺功能测定、纤支镜检查可用于诊断和评估上气道阻塞。肺功能与纤支镜检查,有助于上气道阻塞的诊断与评估,并可用于病情的随访。

Objective To investigate the characteristics of upper airway obstruction （UAO） in order to improve physician＇s recognization and diagnose early. Methods We retrospectively analyzed the clinical features of 76 patients with UAO including etiopathogenisis, clinical manifestations, respiratory function test, bronchoscopy and pathology, from January 2004 to April 2007. Results Of total 76 cases with UAO ,25 % （19/76） were diagnosed with Pulmonary amyloidosis. 23 （30. 26 % ） cases were caused by relapsing polychondritis, 25 （32. 89% ） cases with tumor,10 cases were attributed to tuberculosis;Regarding clinical mainfestatiou,46 out 76 patients had persistent cough, 36 （47.37%） dyspnea ,43 （56.58 % ） hoarseness ,29 （38. 16% ） had expectoration; 56 patients were received spirometry test, Obstructive disturbance pattern of ventilation existed in 27 （48.21% ） and mixed disturbance of ventilation was seen in 14 patients. Bronchoscopy were performed in 70 patients with upper airway involvement showed inflammation, destruction of tracheobronchial cartilage and collapsed tracheobronchial wall in 35 of them;The pathological were seen in 60 patients with UAO. The changes in 16 cases were consistant with that of amyIoidosis,25 cases were in accordance with turner and 10 cases with chronic inflammation in tunica mucosa bronchiorum,5 cases of relapsing polychondritis. Conclusion Respiratory function test, Bronchoscopy are useful in diagnosis in patients with upper airway obstruction.