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2670例肺癌支气管镜下表现与病理类型的关系分析

目的 探讨肺癌组织学类型与纤维支气管镜下形态学的关系, 及纤维支气管镜( 纤支镜) 检查在肺癌的病理诊断中的价值及应用。方法 对2005 年1 月至2008 年6 月经病理证实的 2670 例肺癌患者纤支镜检查结果进行临床和病理回顾性分析。纤支镜检查发现可疑病变后即在直视下钳检、刷检, 送病理学检查。结论 纤支镜下肺癌的形态特点为管内增殖型1467 例( 54. 9% ) 、管壁浸润型723 例( 27. 1% ) 、管外压迫型90 例( 3. 4%) 、混合型326 例( 12. 2% ) 和正常型64 例( 2. 4% ) 。2670 例肺癌中仍以鳞状细胞癌最为常见, 占44. 9% ; 鳞状细胞癌、小细胞癌以中央型为多,在纤支镜下呈现增殖型; 腺癌以周围型为多, 在纤支镜下常呈浸润型。结果 纤支镜检查在肺癌诊断中具有重要价值, 通过纤支镜所见形态特征可以推测肺癌的可能组织类型。

以呼吸道症状为首发的复发性多软骨炎一例

复发性多软骨炎( RP) 是一种原因不明、少见的、累及全身多系统的疾病, 表现为反复发作和缓解及进展性炎性破坏性病变等特点, 常累及软骨和其他全身结缔组织。本病好发于耳、鼻、咽、喉、气管、支气管和关节等软组织, 进而可累及多系统。部分患者以呼吸道受累为首发表现, 现报告1 例。．．．．．．

良性气道狭窄病因分析及治疗方式总结

目的 探讨良性气道狭窄病因分析及治疗方式。方法 收集2006 年1 月至2010 年5月期间四川大学华西医院经胸部CT、纤维支气管镜或手术、病原学、病理学确诊为良性气道狭窄的住院患者100 例。对患者的病史特点、胸部影像学检查、纤支镜镜下表现、手术所见、病原微生物、病理结果及治疗方式进行统计分析。结果 在良性气道狭窄患者中, 支气管结核60 例( 60% ) , 气管切开术后15 例( 15% ) , 创伤后6 例( 6% ) , 气管插管后3 例( 3% ) , 支气管吻合术后3 例( 3% ) , 甲状腺肿3 例( 3% ) , 复发性多软骨炎2 例( 2% ) , 良性肿瘤4 例( 4%) , 其他原因4 例( 4%) 。结论 良性气道狭窄的病因常见原因是结核性, 起病较隐匿, 临床医生应注意排查肺结核患者有无气道狭窄。纤支镜下的介入治疗为治疗良性气道狭窄的主要方法。

存留于右侧中间支气管长达14年的支气管异物一例

重组人干扰素α-2b成功治疗支气管乳头状瘤一例

体外膜肺支持下经硬质支气管镜 Y 型金属覆膜支架置入一例

Analysis of Clinical Effects about High Intensity Focused Ultrasound in Treatment of 8 Hepatic Echinococosis

ObjectiveTo explore the safety and effectiveness of high intensity focused ultrasound (HIFU) in treatment of hepatic echinococcosis. MethodsThe clinical data of 8 patients with hepatic echinococcosis from 2008 to 2010 in the HIFU treatment center of The Second Affiliated Hospital of Chongqing Medical University were analyzed retrospectively, the effect of HIFU treatment, postoperative liver area pain, fever, skin burn and other complications were evaluated, the prognosis and recurrence were followed-up. ResultsAll the clinical manifestations and imaging manifes-tations of these 8 patients were improved after HIFU treatment. The liver functions of all the patients were injuried, which all were returned to normal within 5 days. Three patients suffered from fever and recovered within 6 days. Six patients appeared pain of liver area and relieved within 7 days. Operation area skin was basically normal, except 3 cases of mild swelling, no special complications happened. ConclusionFrom the limited data initially shows that it is a safe and effec-tive method of HIFU in treatment of hepatic echinococcosis, which is little invasion and less postoperative complications.

M 形皮瓣在儿童 Wassel Ⅳ型复拇指畸形合并虎口狭窄矫形术中的应用

目的总结儿童 Wassel Ⅳ型复拇指畸形合并虎口狭窄矫形术中应用 M 形皮瓣修复创面的疗效。方法2010 年 5 月—2018 年 12 月，收治 10 例Wassel Ⅳ型复拇指畸形合并虎口狭窄患儿。男 7 例，女 3 例；年龄 1～5 岁，平均 1.9 岁。轻度虎口挛缩 5 例，中度 5 例。术中切除桡侧指体并开大虎口后，应用 M 形皮瓣修复创面。结果术后皮瓣均成活，创面Ⅰ期愈合。患儿均获随访，随访时间 8～15 个月，平均 12 个月。患儿家属对拇指外形满意，拇指对掌及对指功能良好，虎口未进一步挛缩。末次随访时，根据改良 Tada 评分标准，获优 9 例、良 1 例，优良率 100%。结论儿童 Wassel Ⅳ型复拇指畸形合并虎口狭窄矫形术中，采用 M 形皮瓣修复重建虎口，操作简便，不增加额外损伤，疗效满意。

经支气管镜治疗声门下气管血管球瘤一例

Value of maximum amplitude of thrombus in thromboelastogram in predicting occurrence of venous thrombosis in patients after lung cancer surgery

ObjectiveTo explore the predictive value of the maximum amplitude (MA) in the thromboelastogram (TEG) in the occurrence of venous thromboembolism (VTE) in patients with lung cancer after surgery.MethodsForty-one lung cancer patients with postoperative VTE in our hospital from September 2018 to August 2020 were enrolled into a thrombosis group, including 25 males and 16 females, aged 72.17±10.08 years. The 87 lung cancer patients who underwent surgery during the same period but did not suffer postoperative VTE were enrolled into a control group, including 51 males and 36 females, aged 71.06±9.49 years. The MA of thrombus in the TEG before and after the operation was compared between the two groups, and logistic regression analysis was used to test the value of the MA of thrombus at each time point in the TEG to predict the occurrence of VTE in patients with lung cancer surgery. The receiver operating characteristic curve was drawn to test the effectiveness of the MA of thrombus at each time point in the TEG to predict the occurrence of VTE in patients with lung cancer.ResultsThe MA of thrombus in the two groups after operation was greater than that before operation, and the MA of thrombus in the TEG on the day 3 after operation in the two groups> day 1> day 5 (P<0.05). The logistic regression analysis showed that the MA of thrombus in the TEG increased, which had predictive value for the occurrence of VTE in patients with lung cancer after surgery; the MA of thrombus in the TEG at each postoperative point was used as the test variable. Taking the occurrence of VTE as a state variable, the area under the curve (AUC) of MA of thrombus in the TEG on the 1st postoperative day was 0.82, and its optimal threshold was 75.15 mm; on the 3rd postoperative day, AUC was 0.88, and its optimal threshold was 80.05 mm; on the 5th day afterwards, AUC was 0.78, and its optimal threshold was 66.30 mm.ConclusionThe MA of TEG has a high predictive power for the occurrence of VTE in lung cancer patients after surgery, which suggests that TEG dynamic monitoring should be performed before surgery for lung cancer patients, and a reasonable anticoagulation plan should be formulated accordingly to reduce the occurrence of VTE.