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目的：探讨纤支镜检查术在气管、隆突癌诊断中的作用及对有明显大气道阻塞、呼吸困难严重患者术前如何建立通畅的气道和术中、术后的处理。方法：采用Ｏｌｙｍｐｕｓ－ Ｂ３Ｒ 和ＢＦ－ Ｐ２０ 型纤支镜经鼻腔插入，术前用药和麻醉均按一般纤支镜检查常规，发现病变取组织活检和刷检，送组织病理和刷检涂片脱落细胞检查；对于瘤体大，气管腔大部阻塞的患者，应在术前建立通畅的气道，据情作气管切开，放置气管套管或在纤支镜引导下，气管内插入细塑料导管，且在术中、术后气管内滴入地塞米松和肾上腺素，并于术后常规服用强的松３ｄ。结果：５２ 例肿瘤主体均在气管和（或） 隆突，病理类型为类癌６ 例，鳞状细胞癌３１ 例，腺癌４ 例，小细胞未分化癌９ 例，腺样囊性癌２ 例。结论：纤支镜检查是诊断气管、隆突癌的重要手段，它既能直视肿瘤的部位、范围、形态，又能取活组织和刷检涂片，得到组织学和病理学诊断。另外在气管、隆突癌的诊断中应重视高电压Ｘ线胞片和气管断层摄影检查
Objective: To investigate the role of fibrobronchoscopy in the diagnosis of trachea and protuberances and how to establish a smooth airway and to perform intraoperative and postoperative treatment for patients with significant airway obstruction and severe dyspnea. Methods: Olympus-B3R and BF-P20 fiberoptic bronchoscopes were inserted through the nasal cavity. Preoperative medication and anesthesia were performed according to general fiberoptic bronchoscopy. The lesions were taken for tissue biopsy and brush examination, and histopathology and brush smear were removed. Cellular examination; For patients with large tumors and most obstructed airway lumens, a smooth airway should be established prior to surgery. Tracheostomy should be performed as appropriate. Place tracheal cannula or under the guidance of fiberbronchoscope to insert fine plastic into the trachea. Catheters, and dexamethasone and epinephrine were instilled into the trachea during and after surgery, and prednisone was taken 3 days after surgery. RESULTS: The main body of the 52 cases was trachea and/or carina. The pathological types were 6 cases of carcinoid, 31 cases of squamous cell carcinoma, 4 cases of adenocarcinoma, 9 cases of small-cell undifferentiated carcinoma, and adenoid cystic carcinoma 2 example. Conclusion: Fibrobronchoscopy is an important method for the diagnosis of trachea and protuberances. It can not only look directly into the location, extent and shape of the tumor, but also can take live tissue and brush smears to obtain histological and pathological diagnosis. In addition, attention should be paid to the examination of high-voltage X-ray and tracheal tomography in the diagnosis of trachea and protuberances