支气管内型错构瘤临床病理学特征及气管镜下热消融联合冷冻治疗

Clinical and pathology characters of endobronchial hamartoma and bronchoscopic treatment with thermal ablation and cryotherapy

目的探讨支气管内型错构瘤的临床诊断、病理学特征及经气管镜下热消融联合冷冻治疗方法。方法收集北京友谊医院呼吸科2010—2012年间，经气管镜下切除及病理确诊的支气管内型错构瘤病例3例，探讨支气管内型错构瘤的临床病理学特征和经气管镜下介入治疗方法。结果经气管镜下可完全切除支气管内肿瘤。肿瘤病理结果为良性错构瘤。术后气道完全开通，术后无严重并发症，随访无复发。结论支气管内型错构瘤发病以成人为主，影像学表现为叶段支气管开口处软组织影伴远端炎症及肺不张，气管镜下常规活检取得组织体积小，不易确诊，需取大块瘤体进行病理确诊。气管镜下热消融联合冷冻治疗，能快速切除瘤体，同时避免切除部位瘢痕狭窄，效果良好。

Objective To discuss the clinical and pathology characters of endobronchial hamartoma and bronchoscopic treatment with thermal ablation and cryotherapy. Methods Three cases ofendobronehial hamartoma reseeted by bronchoseope and diagnosed by pathology during 2010-2012 were collected,the clinical and pathology characters of endobronehial hamartoma and bronchoseopie treatmentwere discussed. Results The endobronchial tumor was resected completely under the bronchoscope. Pathology of the tumor was hamartoma. The airway was completely opening after the treatment, therewas no serious postoperative complications and recurrence during follow up. Conclusions Endobronchial hamartoma is common in adults, imaging with pulmonary lobe/segments distal bronchus soft tissueshadows along with inflammation and atelectasis. It is difficult to diagnose by conventional bronchoscope biopsy because it is too little, it need to take a chunk of tumor for pathological diagnosis. Thebronchoscopic treatment with thermal ablation and cryotherapy can remove tumors quickly,and avoid the scar stricture at the same time,so it is effective.