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目的研究纤维支气管镜下气管剑鞘状形态改变及其临床意义。方法观察2000-2006年到我院纤维支气管检查室行支气管镜检查,镜下显示胸腔段气管呈剑鞘状改变的74例患者,测量患者内镜下和胸部CT其胸腔段主动脉弓上方10mm层面气管内横径与内矢状径,使用该段气管内横径与内矢状径比值(气管指数)来表示剑鞘状气管形态变化程度。同时分析临床资料及其肺功能检查结果。结果剑鞘气管74例,气管内冠状径的长度范围是6.3~17.6mm,均值为(9.3±3.6)mm,内矢状径的长度范围是13.4~31.8mm,均值为(19.5±6.4)mm,气管指数的范围是0.41~0.68。74例患者均有慢性咳嗽、咳痰病史,68例有慢性阻塞性肺疾病(C0PD)的影像表现,肺功能检查结果显示49例可诊断为中重度阻塞性肺通气功能障碍。结论剑鞘气管的形成是由于COPD气管软骨环的损伤、重塑和营养不良性骨化所致,可协助临床诊断中重度COPD。
Objective To study the morphological changes of tracheal scabbard and its clinical significance under fiberoptic bronchoscopy. Methods To observe the bronchoscopy of fibrobronchial examination room in our hospital from 2000 to 2006. The endoscopic and chest CT scan showed that the trachea of the 74 patients were changed to scabbard. The trachea of 10mm above the aortic arch Internal diameter and sagittal diameter, the use of the section of the tracheal diameter and sagittal diameter ratio (tracheal index) to indicate the scabbard tracheal morphology changes. At the same time analysis of clinical data and pulmonary function test results. Results There were 74 cases of scabbard trachea with an average length of 6.3 ~ 17.6mm, an average of 9.3 ± 3.6mm, an internal sagittal diameter of 13.4 ~ 31.8mm and an average of 19.5 ± 6.4mm , Tracheal index ranged from 0.41 to 0.68.74 patients had chronic cough, sputum history, 68 cases of chronic obstructive pulmonary disease (C0PD) imaging performance, pulmonary function tests showed that 49 cases can be diagnosed as moderate to severe obstruction Sexual lung ventilation dysfunction. Conclusions The formation of scabbard trachea is due to injury, remodeling and malnutritional ossification of COPD tracheal cartilage ring, which may be helpful for the clinical diagnosis of moderate-severe COPD.