咳喘患儿气管支气管异物的检出

气管支气管异物是引起小儿咳喘的重要原因之一。本文就X线诊断中的几点体会作了详细介绍,认为X线检查对气管支气管异物的诊断和治疗有极为重要的价值。     

多层螺旋CT三维成像行国人气道径线分析

目的探讨国人气管和主支气管各种解剖径线的长度与角度.方法用多层螺旋CT三维成像法测定300例成年健康体检者锁骨胸骨端水平气管内径、锁骨胸骨端水平到隆突的气管长度,左、右主支气管和右中间支气管内径与长度,以及左、右主支气管长轴与矢状面的夹角.结果男性气管、左、右主支气管、右中间支气管内径与长度,以及右上肺叶支气管开口内径均大于女性,而女性左、右主支气管长轴与矢状面夹角均大于男性(p<0.05或0.01).成年人与老年人上述各解剖径线值差异无显著(p>0.05).左主支气管内径值与右主支气管内径值呈高度相关,且分别与气管内径值和身高呈高度相关(p<0.01).结论通过多层螺旋CT三维成像法测定国人气管、左和右主支气管径线值,获左、右主支气管内径值与患者身高和气管内径测量值的回归方程,可预测其左、右主支气管内径值.     

儿童气管、支气管非金属异物的影像学诊断

目的 探讨气管、支气管非金属异物的影像学表现，提高对该病的早期诊断率。方法 回顾性分析了60例气管、支气管非金属异物的临床与影像学征象。结果 本组60例中，右侧支气管异物32例，左侧支气管异物22例，主气管异物6例。常见的影像学表现为阻塞性肺气肿51例，纵隔摆动48例。结论 病史及影像学表现是诊断气管、支气管非金属异物的主要手段。     

儿童支气管类癌的病理诊断(附2例报告)

目的探讨儿童支气管类癌的临床病理学特征及病理诊断。方法结合我院2例临床资料及组织学观察和免疫组化研究复习有关文献进行分析讨论。结果2例均为中央型支气管类癌,瘤细胞排列成实性片状、小梁状及乳头状;细胞大小一致,胞浆嗜酸性,胞核圆形,核分裂罕见。免疫组化标记CK、Syn、CgA及NSE均阳性。结论儿童支气管典型类癌为高分化神经内分泌癌。由于支气管肿瘤在儿童较罕见,临床症状缺乏特异性,极易引起临床误诊,延误治疗,须引起高度重视。     

内服外敷疗法治疗支气管哮喘32例疗效观察

目的观察内服外敷疗法治疗支气管哮喘缓解期疗效。方法对64例患者采用随机分组,治疗组32例,并与西药治疗的对照组32例进行比较。结果治疗组总有效率为93.75%,对照组总有效率为81.25%,两组比较差异有统计学意义（P〈0.05）。结论内服外敷疗法治疗支气管哮喘缓解期有效。     

三叶因子2在慢性支气管哮喘大鼠肺组织中的表达

目的：进一步探讨三叶因子2(TFF2)在慢性支气管哮喘(简称哮喘)大鼠肺组织中的表达。方法24只雄性 Wistar 大鼠随机分为3组(每组8只)：①正常大鼠组(A 组)：无特殊处理。②鸡卵白蛋白(ovalbumin,OVA)致敏生理盐水吸入组(B 组)：应用 OVA 致敏大鼠,生理盐水激发；③慢性哮喘组(C 组)：应用 OVA 致敏和反复激发的方法制备大鼠慢性哮喘模型。各组大鼠于末次激发后24 h 处死。ELISA 法测定 BALF 中 TFF2水平；肺组织标本行 HE 染色、PAS 染色及Masson 三色染色,并行病理图像形态学测定和分析；免疫组织化学检测大鼠气道上皮细胞 TFF2的表达。结果 C 组大鼠气道上皮细胞 TFF2的表达与 A 组及 B 组相比明显增多(A 组与 C 组比较 q =74.51,P <0.01,B 组与 C 组比较 q =71.93,P <0.01)。C 组大鼠 BALF 中 TFF2水平与 A 组及 B 组相比明显增高(A 组与 C 组比较 q =7.16,P <0.01,B 组与 C 组比较 q =6.13,P <0.01)。结论TFF2在慢性哮喘大鼠肺组织中表达增多。     

癌性气道梗阻腔内冷冻及支架治疗

目的：探讨中晚期癌灶侵犯气管、支气管导致大气道梗阻、呼吸困难的姑息性救治方法。方法：21例气管、支气管癌性梗阻伴呼吸困难患者，6例伴声音嘶哑，8例伴左或右全肺不张，21例均伴肺部感染及呼吸困难。经纤支镜插入CO2冷冻软探针冷冻摘除肿瘤和／或植入带膜钛合金网状内支架救治。结果：17例气道梗阻、呼吸困难及两肺感染患者获完全缓解；2例气道梗阻获部分缓解，呼吸困难及两肺感染减轻；1例患者于等待定做内支架过程中死亡，1例气管重度梗阻，于表面麻醉、纤支镜观察中出现窒息，经呼吸机支持24小时后死亡。结论：癌肿转移、侵入气管、支气管后于腔内生长迅速，短期即可导致气道阻塞、呼吸困难死亡。对终末期患者，经纤支镜插入CO2冷冻软探针冷冻摘除肿瘤和／或植入带膜钛合金网状内支架救治方法，虽然风险大，但仍提供了一条有效的救治途径，为继续治疗赢得了宝贵时间。     

Acetamide-45抑制电场刺激及醋氯甲胆碱引起的离体气道收缩

目的:探讨新型抗变态反应药N-对氟苄基-3-[(N-4-吡啶)-乙酰胺]-吲哚-45 (acetamide-45)对电场刺激引起的大鼠离体气管/支气管收缩,及醋氯甲胆碱引起的豚鼠离体气管收缩的影响.方法:以acetamide-45预处理标本后,①记录电场刺激引起胆碱能神经兴奋所致的标本收缩,观察acetamide-45的作用;②以累积剂量法给予醋氯甲胆碱,观察acetamide-45对醋氯甲胆碱量效曲线的影响,气管张力的变化通过换能器转变为电信号并由记录仪记录.结果:Acetamide-45 (1～30 μmol·L-1)能浓度依赖性地抑制电场刺激引起的大鼠气管/支气管的胆碱能收缩,其在气管的IC50(95%可信限)为10.74(8.87～13.00)μmol·L-1,在支气管的IC50(95%可信限)为18.83(14.57～24.33)μmol·L-1.Acetamide-45浓度依赖地抑制醋氯甲胆碱引起的豚鼠离体气管收缩,3～30 μmol·L-1 acetamide-45使醋氯甲胆碱的量效曲线的最大效应下降24.6%～43.2%,EC50增大3.1～21.4倍.结论:acetamide-45抑制离体气道平滑肌收缩的作用,可能是通过非特异性抑制乙酰胆碱和胆碱能受体结合而产生的.     

Clinical trial of razoxane and radiotherapy for inoperable carcinoma of the bronchus.

One hundred thirteen patients with inoperable carcinoma of the bronchus were ramdomly allocated to receive either radiotherapy or radiotherapy plus razoxane. They were stratified according to histology and analyzed according to whether they had oat-cell or non oat-cell carcinomas and whether they tolerated only 1 course (3,000 rad) or 2 courses (6,000 rad) of radiotherapy. Of the patients who had 2 courses of radiotherapy, only 7% developed leukopenia and the same percentage developed severe esophagitis; but of those who had the combined treatment, 32% developed leukopenia and the same pecentage developed severe esophagitis.Although the median survival time was greater in those who received the combined treatment in both one treatment and two treatment groups, neither achieved statistical significance. Sixty four percent of patients who had two treatments (i.e. 6,000 rad plus razoxane) survived 12 months; this compares favorably with most other published clinical trials of inoperable carcinoma of the bronchus.     

Morphologic findings in central bronchi correlated to lung function data in obstructive airways disease.

Quantitative analyses of morphologic findings are the condition of clinico-pathological correlation studies. These quantitative analyses are possible by morphometry. The present correlation study shows that morphometry may therefore contribute to understanding the pathogenesis of obstructive airways disease: decreasing bronchial lumen and increasing volume of grandular ducts are correlated to increasing airways resistances (clinical parameters: RAW, FEV1). Increasing volume of bronchial muscles is correlated with resistance of airways at quiet breathing (RAW) and less with increasing residual volume (RV). Increasing volume of bronchial glands and glandular ducts is correlated with increasing resistance at forced expiration which is clinically shown by decreasing FEV1. These findings can be interpreted as follows. Airway resistances are mainly influenced by airway narrowing.At quiet breathing, muscle constriction is an additional cause of increasing airflow resistance due to bronchial narrowing. At forced expiration, however, mucus plugs probably limit the airflow because thickening of bronchial glands points to increased secretory activity. Until now it is not possible to understand why bronchial muscle volume correlates with residual volume.