王姝 吴越 宋斌

[摘要] 收集我院呼吸内科确诊的骨化性气管支气管病2例，结合文献进行分析。2例患者为51岁男性和55岁女性，分别表现为胸背部疼痛和胸闷，胸部CT示气管、支气管管壁不均匀增厚并见小结节状钙化影突向管腔，电子支气管镜下均表现为气管、支气管腔多发结节样突起，质硬。支气管镜活检病理诊断均为骨化性气管支气管病。2例患者均经抗感染、祛痰治疗后病情好转出院。骨化性气管支气管病无特异性临床症状，医师对该病认识不足，导致其易被漏诊、误诊，故诊断率低。在临床工作中，建议对有胸闷、胸痛、咯血等呼吸道症状但诊断不明的患者行电子支气管镜及胸部CT检查，排查骨化性气管支气管病，提高该病的诊断率。

[关键词] 骨化性气管支气管病;电子支气管镜;胸痛;电脑断层扫描

[中图分类号] R562.2          [文献标识码] C          [文章编号] 1673-9701（2021）08-0149-04

A report of 2 cases of tracheobronchopathia osteochondroplastica

WANG Shu1   WU Yue2   SONG Bin1

1.Department of Respiratory and Critical Care Medicine， Zibo Central Hospital in Shandong Province， Zibo   255036， China; 2.Department of Vascular Surgery， Zibo Central Hospital in Shandong Province， Zibo   255036， China

[Abstract] A total of 2 cases of tracheobronchopathia osteochondroplastica diagnosed in the Department of Respiratory Medicine of our hospital were collected and analyzed in combination with literatures. The two patients were a 51-year-old male and a 55-year-old female. They showed chest and back pain and chest tightness， respectively. The chest CT showed uneven thickening of the trachea and bronchial tubes and small nodular calcifications protruding into the lumen. And the electronic bronchoscope showed multiple nodular protrusions in the trachea and bronchial lumen with hard quality. The pathological diagnosis of bronchoscopy biopsies were both tracheobronchopathia osteochondroplastica. Both patients were recovered and discharged after anti-infection and expectorant treatment. Tracheobronchopathia osteochondroplastica has no specific clinical symptoms， and doctors have insufficient knowledge of the disease， which makes it easy to be missed and misdiagnosed， and the diagnosis rate is low. In clinical work， it is recommended that patients with respiratory symptoms such as chest tightness， chest pain， hemoptysis， etc. but with an unknown diagnosis should undergo electronic bronchoscopy and chest CT examination to screen tracheobronchopathia osteochondroplastica， and improve the diagnosis rate of the disease.

[Key words] Tracheobronchopathia osteochondroplastica; Electronic bronchoscopy; Chest pain; Computer tomography

骨化性气管支气管病（Tracheobronchopathia osteochondroplastica，TO）是一种罕见的气道良性病变[1]，TO亦被称为气管支气管囊性纤维性骨软骨炎和骨形成性气管病，是以异常的气管、支气管黏膜下骨化和软骨化结节增生突出管腔为特征，一般不累及气道后壁[2]。TO的病理学表现为黏膜上皮基本完整，黏膜上皮可表现为正常或化生，气管、支气管黏膜下软骨或骨形成[3]。TO的临床表现无特异性，慢性咳嗽和喘息是其最常见的临床症状，常被误诊为支气管哮喘[4]。为提高临床医师对TO的认识及诊断率，本文回顧性分析我科收治的以胸背部疼痛、胸闷为主要临床表现的TO患者2例的临床资料，并结合相关文献进行探讨，现报道如下。……