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| 題 名 | Ruptured Mediastinal Mature Teratoma Mimicking Difficult Asthma: A Case Report=以困難性氣喘來表現之縱膈腔錯構瘤 :一病例報告 |
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| 作 者 | 曾士恩; 陳燕溫; 許文虎; 葉奕成; 王家弘; | 書刊名 | 胸腔醫學 |
| 卷 期 | 26:3 2011.06[民100.06] |
| 頁 次 | 頁171-178 |
| 分類號 | 415.425 |
| 關鍵詞 | 困難性氣喘; 縱膈腔錯構瘤; Difficult asthma; Mediastinal mature teratoma; |
| 語 文 | 英文(English) |
| 中文摘要 | 臨床上大氣道阻塞可以氣喘急性發作來表現,若是病人以標準氣喘治療方式治療後仍無法獲得有效的改善時,就要考慮是否有其他可能之致病因包括大氣道阻塞。本案例是一名61歲女性一開始即以氣喘發作來表現,在類固醇及氣管擴張劑治療數週後症狀反而加重,進而發生呼吸衰竭的情形。在插管使用呼吸器後一週,發現一縱膈腔膿瘍而緊急接受導管引流。在拔管後病人一直有反覆出現之呼吸道症狀而接受系列之影像追蹤,且發現有一快速生長之氣管內腫瘤。一開始的病理切片只有鱗狀上皮異化,病人接受多次雷射腫瘤燒灼,但此腫瘤仍持續快速生長。最後病人接受氣管內腫瘤摘除術及部分氣管切除,而手術病理顯示為一縱膈腔良性錯構瘤。手術後病人症狀完全消失。 |
| 英文摘要 | The clinical presentation of central airway obstruction may mimic asthma. If a patient fails to respond to standard asthma treatment, an alternative diagnosis should always be considered. We described a 61-year-old female who initially presented diffuse wheezing and was treated for asthma. The patient had a poor response to asthma treatment and respiratory distress persisted. Endotracheal intubation and mechanical ventilator support had to be initated. A mediastinal abscess was found 7 days after endotracheal intubation and required catheter drainage. After successful weaning from the ventilator, serial imaging studies revealed a tracheal tumor. Bronchofiberscopic biopsy was performed and the pathology disclosed squamous dysplasia. Nd-Yag laser tumor ablation was performed several times, but rapid recurrence of the tumor was observed. The patient underwent removal of the tumor and segmental tracheal resection. The pathology confirmed the tumor as a ruptured mediastinal mature teratoma. After surgery, the patient's symptom completely disappeared. |
本系統中英文摘要資訊取自各篇刊載內容。