复发性多软骨炎致气道狭窄的诊断与治疗

The Diagnosis and Treatment of Airway Stenosis in Relapsing Polychondritis

目的探讨复发性多软骨炎致气道狭窄的诊断及治疗方法。方法报道2例累及气道的复发性多软骨炎患者的临床资料,总结其诊断和治疗经验,并进行相关文献复习。结果2例患者均为老年男性,临床表现均有咳嗽、呼吸困难、耳廓萎缩和鼻梁塌陷,在基层医院均被误诊;肺功能示阻塞性通气功能障碍,胸部CT示气管主支气管管壁增厚、管腔变窄,可弯曲支气管镜检查示气管支气管软骨消失、管腔狭窄、呼气相部分气道陷闭,病理检查为慢性炎症;2例患者均予以糖皮质激素和气道金属支架置入治疗后病情改善。结论复发性多软骨炎致气道狭窄患者容易误诊,胸部CT和可弯曲支气管镜能明确诊断,糖皮质激素联合气道内支架置入等治疗能改善患者病情。

Objective To explore the diagnosis and treatment of airway stenosis reduced by relapsing polychondritis （RP） Methods The clinical data of 2 patients with relapsing polychondritis involving the airway were reported and the relative literatures were also reviewed. Results The two patients were both old male, with clinical manifestations of cough, dyspnea, and ear atrophy and nose bridge sink. They were misdiagnosed in a grass - roots hospital. The pulmonary function tests showed obstructive venfilatory disorder. Thoracic CT scan demonstrated a diffusely thickened tracheobronchial wall with tracheobronchial stenosis. Bvonchoseopy revealed disappearance of tracheobronchi with airway stenosis and partly obliteration of both the trachea and main bronchi on expiration. Pathological results were chronic inflammation. They were relieved by medication of corticostevoids and metallic stent placement. Conclusion The relapsing po]ychondritis with airway stenosis is easy to be misdiagnosed. Thoracic CT and flexible bronchoscopy can be used for a definite diagnosis. And corticosteroids plus metallic stent placement in airway can relieve dyspnea and improve the condition of the patients.