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梗阻性毛细支气管炎(OB)是继下呼吸道损伤后纤维组织增生所致的以支气管、毛细支气管部分或完全性梗阻为特征的少见病。本文对儿童OB 的临床、X 线及组织学特点做了回顾性研究,旨在明确该病的临床表现及其早期诊断方法。病例选自美国费城的圣克斯托弗儿童医院1960～1985年全部尸检(n=2897)的肺活检或肺叶切除(n=244)儿童。对尸检及肺活检确诊的OB、支气管炎、坏死性支气管炎和支气管肺炎进行病理学检查。OB 的组织学诊断通过阻塞支气管腔的细胞团块或瘢痕而获得。复习原始的X 线胸片,并将通气灌注扫描发现的放射性缺损与支气管造影的变化(包括周围支气管、末端细支气管的充盈情况及在呼吸道正压下肺泡的充气情况)进行对比做出X 线诊断。结果将放射学和组织学确诊的19例OB 分为两组:1组12例生前确诊(其中10例存活);2组7例尸检证实。1组症状发作年龄平均3岁。全部于冬季出现咳嗽、气促、发热等肺炎症状。物理检查局部均可
Obstructive bronchiolitis (OB) is a rare disease characterized by the partial or complete bronchial and bronchiolar bronchial obstruction caused by fibrous tissue hyperplasia after lower respiratory tract injury. In this paper, the clinical, radiographic and histological features of children OB were retrospectively studied in order to clarify the clinical manifestations of the disease and its early diagnosis. The cases were selected from lung biopsy or lobectomy (n = 244) children at all post mortem examinations (n = 2897) from 1960 to 1985 at St. Christopher Children’s Hospital in Philadelphia, PA. OB, bronchitis, necrotizing bronchitis and bronchopneumonia diagnosed by autopsy and lung biopsy were examined by pathology. Histological diagnosis of OB is obtained by blocking the cell mass or scar in the bronchial lumen. Review the original X-ray and compare the radiologic deficits found with the ventilation perfusion scan with changes in bronchography (including the surrounding bronchioles, the filling of the terminal bronchioles, and the inflation of the alveoli under positive airway pressure) diagnosis. Results The 19 OBs diagnosed by radiology and histology were divided into two groups: one group of 12 patients were diagnosed before their death (10 of them were alive) and the other 2 of 7 patients were confirmed by autopsy. A group of symptoms onset age average 3 years old. All in the winter cough, shortness of breath, fever and other symptoms of pneumonia. Physical examination can be local