支气管内型错构瘤1例及文献复习

Endobronchial Hamartoma of the Subsegmental Bronchus: One Case Report and Literature Review

摘要: 目的：提高临床医师对支气管内型错构瘤的认识，强调支气管镜检查及治疗的重要性，减少临床漏诊及误诊率。方法：回顾1例支气管内型错构瘤患者的临床表现、影像学特点及治疗方法，同时以“支气管内型错构瘤”为检索词检索万方数据库，以“endobronchial hamartoma”为检索词检索PubMed数据库，检索时间为2000年1月至2023年1月。结果：本例患者为老年男性，以畏寒、发热、活动后气促等表现就诊，在当地医院误诊为“大叶性肺炎”，常规抗感染治疗效果不理想，遂转至我院，予以气管镜检查发现气管内肿物，通过全麻硬质气管镜下高频震荡通气辅助通气下经球囊扩张、圈套器切除并结合氩气刀烧灼、CO₂冷冻治疗，取出肿物，病理检查诊断支气管内型错构瘤。共检索到相关中文文献79篇，英文文献132篇，临床医师需结合临床表现、影像学特点及气管镜检查准确诊断，以免漏诊、误诊而延误治疗。

Abstract: Objective: To improve clinicians’ understanding of endobronchial hamartoma, emphasize the im-portance of bronchoscopy and treatment, and reduce the rate of clinical missed diagnosis and mis-diagnosis. Methods: the clinical manifestations, imaging features and treatment methods of a pa-tient with endobronchial hamartoma were reviewed. At the same time, Wanfang database was searched with “endobronchial hamartoma” as the key word, and PubMed database was searched with “endobronchial hamartoma” as the key word. The search time was from January 2000 to Janu-ary 2023. Results: The patient was an elderly male who was treated with chills, fever and shortness of breath after activities. He was misdiagnosed as “lobar pneumonia” in the local hospital. The effect of routine anti infection treatment was not ideal, so he was transferred to our hospital for tracheos-copy. Intratracheal tumors were found. Under general anesthesia, high-frequency oscillatory venti-lation under rigid tracheoscopy, assisted ventilation, balloon expansion, snare removal, combined with argon knife cauterization CO₂ cryotherapy, removal of tumor, pathological examination, diag-nosis of endobronchial hamartoma. A total of 79 Chinese and 132 English literatures were retrieved. Clinicians should make accurate diagnosis in combination with clinical manifestations, imaging characteristics and tracheoscopy, so as to avoid missed diagnosis and misdiagnosis and delay treatment.