分析支气管结石(broncholithiasis)的临床特征、诊治方法及预后。

选择2010年1月至2021年12月我院收治的确诊为支气管结石患者26例，收集患者临床资料，分析诊治过程及预后。

26例主要临床特征包括咳嗽24例(92.31%)、咳痰19例(73.08%)和气短9例(34.62%)。影像学表现：支气管腔内高密度影17例(65.38%)，合并肺不张8例(30.77%)，支气管狭窄5例(19.23%)，肺实变4例(15.38%)，空洞1例(3.85%)，胸腔积液1例(3.85%)。支气管结石发病部位：右侧支气管15例(57.69%)，左侧支气管10例(38.46%)，其中左肺上叶6例(23.08%)，右肺上叶6例(23.08%)，右肺中叶5例(19.23%)，左主支气管4例(15.38%)，右肺下叶3例(11.54%)，右肺中间段1例(3.85%)，气道多发结石1例(3.85%)。治疗方式包括一种介入手段15例(57.69%)、两种介入治疗手段9例(34.62%)、三种及以上介入手段2例(7.69%)，手术1例(3.85%)。使用单用活检钳10例(38.46%)和使用活检钳合并其他治疗手段10例(38.46%)。治疗后支气管结石完全清除14例(53.85%)、部分清除10例(38.46%)、未清除2例(7.69%)。无大出血、心衰、恶性心律失常等并发症。治疗前后气道狭窄程度评分及气促指数评分差异有统计学意义(P<0.05)。治疗后气道狭窄程度改善。

支气管结石少见，症状不特异，总体预后良好，可通过支气管镜介入手段清除，复发率低，结石侵犯血管或内镜介入清除失败应考虑手术切除。

To analyze the clinical characteristics, diagnostic and therapeutic methods, and prognosis of patients with broncholithiasis.

It was reviewed that 26 patients diagnosed with broncholithiasis and treated at the Department of Pulmonary and Critical Care Medicine, Tangdu Hospital, Air Force Medical University from January 2010 to December 2021, and collected their clinical data, treatment procedures, and outcomes.

The main clinical features of the 26 patients included cough in 24 cases (92.31%), sputum production in 19 cases (73.08%), and dyspnea in 9 cases (34.62%). Radiological findings showed intrabronchial high-density shadows in 17 cases (65.38%), associated with lung collapse in 8 cases (30.77%), bronchial stenosis in 5 cases (19.23%), consolidation in 4 cases (15.38%), cavity formation in 1 case (3.85%), and pleural effusion in 1 case (3.85%). Locations of bronchial stones included 15 cases in the right bronchus (57.69%) and 10 cases in the left bronchus (38.46%), specifically 6 cases in the left upper lobe (23.08%), 6 cases in the right upper lobe (23.08%), 5 cases in the right middle lobe (19.23%), 4 cases in the left main bronchus (15.38%), 3 cases in the right lower lobe (11.54%), 1 case in the right middle segment (3.85%), and 1 case of multifocal airway stones (3.85%). Treatment modalities included single intervention in 15 cases (57.69%), dual interventions in 9 cases (34.62%), three or more interventions in 2 cases (7.69%), and surgery in 1 case (3.85%). Use of single-forceps biopsy was noted in 10 cases (38.46%), and combined with other therapies in another 10 cases (38.46%). After treatment, complete clearance of bronchial stones was achieved in 14 cases (53.85%), partial clearance in 10 cases (38.46%), and no clearance in 2 cases (7.69%). There were no major complications such as hemorrhage, heart failure, or malignant arrhythmias. There was a statistically significant improvement in airway narrowing scores and dyspnea indices after treatment (P<0.05).

Broncholithiasis is a rare pulmonary disease with nonspecific symptoms and a generally favorable prognosis, which can be effectively managed with bronchoscopic interventions, with a low recurrence rate. Surgical resection should be considered for cases where stones invade vessels or when endoscopic removal fails.