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-  2017 

气管血管瘤一例并文献复习

DOI: doi:10.7507/1671-6205.201610001

Keywords: 血管瘤, 气管, 支气管, 诊断

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Abstract:

目的探讨气管血管瘤的临床表现、诊断、鉴别诊断、病理学特征、治疗及预后,提高对该病的诊疗水平。方法回顾性分析四川大学华西医院收治的 1 例气管血管瘤患者的临床资料并进行相关文献复习。以“气道血管瘤”或“支气管血管瘤”为检索词检索中国期刊网全文数据库、万方数据库及维普数据库,以“Trachea” OR “Bronchus” AND “Hemangioma”为检索词检索 PubMed、Ovid Medline 及 Embase 数据库,检索时间为 1976 年 1 月 1 日至 2016 年 10 月 31 日。结果患者为 32 岁男性,主诉为“背痛、咯血 10 +d”。其胸部增强 CT 提示食管壁全程增厚,食管管腔变窄,纤维支气管镜显示气管及双侧支气管广泛血管瘤样改变,胃镜检查提示食管静脉瘤。患者气管内病变广泛,但经内科保守治疗后,咯血症状明显缓解,随访至今病情未复发。经上述数据库检索,有 34 篇文献 36 例患者明确诊断为气管血管瘤并且具有相关临床资料。其临床症状主要为反复咯血,影像表现不具有特征性,组织病理学表现为扩张、薄壁、管腔大小不一的血管或增生的毛细血管,免疫组织化学染色显示血管内皮细胞特异性 CD34 及 Ⅷ 因子阳性。结论血管瘤是一种常发生于婴儿及儿童头颈部的良性肿瘤,其在成人气管、支气管内极其罕见。病因尚不清楚。临床及影像表现不具有特征性,与淋巴管瘤易混淆。确诊需依赖组织病理学检查,纤维支气管镜及 CT 胸部血管三维重建成像在整个诊治过程中起重要作用。气管血管瘤的预后较好

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