目的 探讨基于可穿戴设备的肺康复模式对慢性阻塞性肺疾病患者康复效果的影响.方法 选取解放军总医院海南医院呼吸与危重症医学科 2019 年 10 月至 2021 年 8 月住院治疗的慢性阻塞性疾病患者为研究对象,先入组的 34 名患者为对照组接受常规的肺康复训练模式,后入组 34 名为试验组给予基于可穿戴设备的肺康复训练模式,比较不同肺康复训练模式对患者出院八周后肺康复效果的影响.结果 干预后 6MWT 结果试验组(443.47±97.04)m对比对照组(389.65±115.64)m、ADL评分试验组(94.41±7.76)分对比对照组(87.65±12.63)分、呼吸频率试验组(19.65±3.87)次/min对比对照组(22.56±3.64)次/min、心率试验组(81.5±99.12)次/min对比对照组(91.35±12.72)次/min差异有统计学意义(P<0.05);干预前后自身比较,试验组6MWT步行距离增加(64.00±57.51)m、ADL评分增加(5.44±6.08)分、呼吸频率下降(3.18±3.70)次/min、心率下降(4.71±8.47)次/min、血氧饱和度上升(1.00±2.17)%、mMRC评分呼吸困难减轻差异有统计学意义(P<0.05).结论 基于可穿戴设备的肺康复研究可以有效改善慢性阻塞性肺疾病患者的呼吸困难症状,提升运动耐量和日常生活活动能力.

目的 观察丙卡特罗联合异丙托溴铵在缓解哮喘患者小气道功能障碍的效果.方法 选取2021 年4 月—2022 年9 月解放军总医院海南医院呼吸内科诊治哮喘患者98 例作为研究对象,按照随机数字表法以1∶1比例分为观察组、对照组,各49 例.对照组采用丙卡特罗治疗,观察组采用丙卡特罗联合异丙托溴铵治疗.治疗2 周后比较2 组疗效,治疗前后临床表现评分、肺功能[第1 秒呼气量(FEV1)、用力肺活量(FVC)、最大呼气峰值流速(PEF)]、小气道功能[用力呼吸50%肺活量(FEF50)、用力呼吸75%肺活量(FEF75)、最大呼气中期流量(MMEF75/25)]以及不良反应发生率.结果 治疗2 周后,观察组总有效率显著高于对照组(93.88%vs.79.59%,χ2/P =4.346/0.037);治疗2 周后观察组各临床表现评分(胸闷、咳嗽、喘息、哮鸣音)均显著低于对照组(t/P =6.141/<0.001、3.940/<0.001、5.824/<0.001、3.957/<0.001),FEV1、FVC、PEF、FEF50、FEF75、MMEF75/25 水平均高于对照组(t/P =2.703/0.008、2.001/0.048、4.810/<0.001、3.382/0.001、5.260/<0.001、3.328/0.001);2 组不良反应发生率比较,差异无统计学意义(χ2/P =0.178/0.674).结论 丙卡特罗联合异丙托溴铵治疗哮喘效果显著,可有效改善哮喘症状,对缓解小气道功能障碍、提高肺功能均有良好效果,安全性高.

OBJECTIVE To investigate the prevalence of anxiety and depression among patients with mild and asymptomatic COVID-19 and explore the influencing factors. METHODS A survey was conducted for the patients with COVID-19 by self-rating anxiety scale（SAS） and self-rating depression scale（SDS）. RESULTS Among 296 patients with COVID-19 whose questionnaires were valid, 76（25.7%） presented with anxiety, 64（21.6%） of whom were mild anxiety, 12（4.1%） were moderate anxiety, and no patient had severe anxiety. 147（49.7%） patients presented with depression, 104（35.1%） of whom were mild depression, 41（13.9%） were moderate depression, and 2（0.7%） were severe depression. The incidence of anxiety was 36.9% among the patients with mild COVID-19 and 21.4% among the patients with asymptomatic COVID-19（P＜0.05）; the incidence of depression was 47.7% among the patients with mild COVID-19 and 49.0% among the patients with asymptomatic COVID-19; there were no significant differences. The incidence of anxiety and depression was higher among female patients than among the male patients（P＜0.05）. The SAS score of the patients with mild COVID-19 was higher than that of the patients with asymptomatic COVID-19（P＜0.05）; the SAS and SDS scores of students and retirees were lower than those of other occupations（P＜0.05）; there was significant difference in the SDS score among the COVID-19 patients with different education levels or age groups（P＜0.05）. CONCLUSION The incidence of anxiety and depression remains high among the patients with mild or asymptomatic COVID-19. It is necessary to take corresponding intervention measures so as to relieve the negative mental state.

Objective:To analyze the clinical characteristics of hospitalized patients with bronchiectasis in Hainan Province, and to summarize the disease characteristics.Methods:This was a cross-sectional study involving 207 hospitalized bronchiectasis patients in the Hainan Hospital of Chinese PLA General Hospital from May 2012 to January 2022.Their final diagnosis recorded in the inpatient medical record information management system were bronchiectasis, bronchial dilation, bronchiectasis with infection, or bronchiectasis with hemoptysis.Chest high-resolution CT image data were available.Baseline characteristics, imaging manifestations, pulmonary function and sputum microbial culture data of the enrolled patients were collected.Clinical symptoms, signs, pulmonary function and sputum microbial detection rate of bronchiectasis patients with varying morphological manifestations (columnar, cystic columnar, cystic) were compared.The detection rate of sputum microorganisms in bronchiectasis patients with different distribution ranges (single lobe involvement and multiple lobes involvement) were compared.Lung function differences between bronchiectasis patients with or without specific bacteria were compared.The results of drug sensitivity test of Pseudomonas aeruginosa were analyzed.Results:A total of 207 cases were recruited, including 110 males (53.14%) and 97 females (46.86%).The mean age was (64.37±13.91) years.The elderly aged 65 years and above accounted for 55.07% (114/207).The mean age of onset was 50.73±19.39 years.History of tuberculosis, chronic obstructive pulmonary disease, bronchial asthma, interstitial pneumonia and immunosuppression due to long-term glucocorticoid treatment of tumors, leukemia, nephrotic syndrome and other causes was detected in 23.19% (48/207), 21.74% (45/207), 5.80% (12/207), 3.38% (7/207) and 9.66% (20/207) of cases, respectively.The cause of the disease could not be determined in most of patients, and only 15.46% (32/207) had identified causes; 59.38% (19/32) of bronchiectasis patients were caused by pulmonary tuberculosis.The main symptoms were cough (89.37%), expectoration (82.61%), shortness of breath (43.96%) and hemoptysis (30.43%).Cylindrical (47.34%, 98/207), mixed (16.43%, 34/207) and saccular lesions (36.23%, 75/207) were found in imaging examinations; 30.43% (63/207), 69.57% (144/207) and 18.84% (41/207) of patients had the involvement of a single lobe, multiple lobes and all lobes, respectively.Among the involved lung lobes, the right lower lobe accounted for 57.49% (119/207).Seventy-three patients underwent pulmonary function examination during hospitalization, of which 67.12% (49/73), 54.79% (40/73) and 39.73% (29/73) had obstructive ventilatory disorder, restrictive ventilatory disorder, and mixed ventilatory disorder, respectively.According to the imaging classification, there was significant difference in the percentage of forced expiratory volume in the first second to the predicted value (FEV 1%pred) of bronchiectasis patients with cylindrical, saccular and mixed lesions ( F=4.41, P=0.016), while no significant differences were found in the percentage of forced vital capacity in the predicted value (FVC% pred) and the percentage of forced expiratory volume in the first second to the predicted value (FEV 1/FVC)(both P>0.05).A total of 184 sputum samples were collected for microbial culture during hospitalization, and the positive rate was 57.07% (105/184).101 cases (54.89%) were positive for bacteria and 22 cases (11.96%) were positive for fungi.A total of 147 strains of 26 kinds of bacteria were cultured, including 136 strains of 19 Gram-negative bacteria and 11 strains of 7 Gram-positive bacteria.Two or more kinds of bacteria were detected in 34 (18.48%) cases.The bacteria with a high composition included the Pseudomonas aeruginosa 38.10% (56/147), Klebsiella pneumoniae 14.29% (21/147), and Acinetobacter baumannii 11.56% (17/147).The detection rate of Pseudomonas aeruginosa in bronchiectasis patients with the involvement of multiple lobes was significantly higher than that in those with single lobe involvement (39.53% [51/129] vs 9.09% [5/55], χ2=19.12, P<0.001).The pulmonary function indexes of bronchiectasis patients with Pseudomonas aeruginosa infection were significantly lower than those without Pseudomonas aeruginosa infection ( P<0.05). Conclusions:Bronchiectasis is common in the elderly in Hainan Province, and the etiology is unclear.The proportion of patients with previous tuberculosis infection is high.The clinical symptoms are various, and most of the pulmonary functions have obstructive ventilatory disorder.The imaging features mainly include cylindrical bronchiectasis and the involvement of multiple lobes.The detection rate of Gram-negative bacteria in sputum samples is high, and the detection of Pseudomonas aeruginosa is associated with lung dysfunction.

目的 探讨肺曲霉菌病(PA)患者的临床特征、诊断和治疗意义,提高对肺曲霉菌病的认识.方法 回顾性分析解放军总医院海南医院2012年6月-2020年3月收治的50例肺曲霉菌病患者的一般情况、临床症状、实验室检查、胸部CT、支气管镜检查、组织病理、治疗及转归,分析其临床特点.结果 50例患者,临床表现无特异性,无粒细胞缺乏,危险因素为低白蛋白血症、抗菌素使用、糖皮质激素,合并基础疾病为糖尿病、哮喘、慢性阻塞性肺疾病等,肺部影像学表现有双肺多发病灶、片状阴影、结节、空气新月征、空洞、晕轮征.GM试验、G试验阳性率均为54.0％;下呼吸道痰曲霉培养为主要方法,占42.0％.经治疗74.0％好转、6.0％无效,复发4.0％,16.0％失访.结论 肺曲霉菌病并不少见,临床表现复杂多样,缺乏特异性,诊断上依赖于微生物培养和组织活检,通过早期影像学特点、实验室检查,气管镜肺泡灌洗、培养等进行鉴别,经气道内镜检可以提高早期确诊,部分病例需进一步活检确诊,尽早治疗提高预后.

目的 探讨膀胱癌病人癌组织中Dickkopf相关蛋白2(DKK2)的表达及与预后的关系.方法 2016年5月～2018年6月我院收治的拟行手术治疗的膀胱癌病人86例,收集病人膀胱癌组织标本和癌旁组织(距癌组织≥5 cm),比较癌组织、癌旁组织中DKK2表达情况.分析癌组织中DKK2表达与临床病理特征的关系.Cox回归分析影响膀胱癌病人预后的因素.分析癌组织中DKK2表达与膀胱癌病人预后的关系.结果 膀胱癌组织DKK2阴性表达率高于癌旁组织,差异有统计学意义(P<0.05).不同性别、年龄、体质量指数(body mass index,BMI)、吸烟、饮酒、肿瘤数量膀胱癌病人癌组织中DKK2阴性表达率比较,差异无统计学意义(P>0.05);肿瘤最大径≥3 cm、临床分期Ⅲ～Ⅳ期、有淋巴结转移、低分化、脉管侵犯膀胱癌病人癌组织中DKK2阴性表达率分别高于肿瘤最大径<3 cm、临床分期Ⅰ～Ⅱ期、无淋巴结转移、中/高分化、无脉管侵犯病人,差异有统计学意义(P<0.05).86例膀胱癌病人术后随访3年,共失访5例,81例病人中19例死亡,病死率为23.46％.Cox回归分析显示,临床分期、淋巴结转移、分化程度、DKK2阴性是影响膀胱癌病人预后的独立影响因素(OR=3.018、2.267、3.184、4.645,P<0.05).截止随访结束,DKK2阳性、DKK2阴性膀胱癌病人存活率分别为94.44％、71.43％.DKK2阳性表达病人与DKK2阴性表达病人生存曲线比较,差异有统计学意义(P<0.05).结论 膀胱癌组织中DKK2阴性表达率较高,DKK2表达与膀胱癌病人肿瘤最大径、临床分期、淋巴结转移、分化程度及脉管侵犯及预后均具有一定的相关性,监测其表达情况对膀胱癌病人预后评估具有重要参考价值.

目的 分析医院40例机化性肺炎(OP)的临床特点,提高对隐源性机化性肺炎(COP)和继发性机化性肺炎(SOP)的诊治认识.方法 收集40例OP患者,其中COP组23例,SOP组17例,分析患者临床症状、实验室检查、影像学特点、病理检查、治疗疗效的临床资料,进行比较总结分析.结果 COP组与SOP组临床表现、影像学检查、组织病理无特异性,比较差异无统计学意义;两组C-反应蛋白(CRP)比较差异有统计学意义(P<0.05);肺部影像学边界不清斑片实变影两组有统计学意义(P<0.05);激素是治疗OP的主要方式,COP与SOP激素治疗上无明显差异,SOP治疗需同时治疗基础疾病.结论 COP与SOP临床表现、实验室检查差异性小,影像学及组织病理学一定程度上可以鉴别,治疗均以糖皮质激素为主,大环内酯类药物也可以作为替代治疗,SOP需同时治疗原发疾病,手术治疗有一定参考价值.

阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)和慢性阻塞性肺疾病(chronic obstructive pul-monary disease,COPD)都是较常见的慢性呼吸系统疾病.OSA是与睡眠相关的特定呼吸障碍,其特征是睡眠期由于间歇性上气道部分或完全塌陷,反复出现呼吸停止并伴有间歇性低氧血症.COPD是一种可预防和可治疗的系统性疾病,其特征是持续的呼吸道症状和气流受限,由于气道阻塞、肺过度膨胀和呼吸肌损伤引起通气减少,进而出现低氧血症和高碳酸血症.这两种疾病的共存被称为重叠综合征(overlap syndrome,OVS),由Flenely于1985 年命名[1-3].

根治性膀胱切除术是肌层浸润性膀胱癌治疗的金标准,该手术创伤大,术中术后并发症发生率较高,有部分患者不愿意接受该手术治疗.我院2012-03至2020-04选取26例采用RevoLix 2 μm激光保留膀胱手术治疗,术后辅以静脉化疗,疗效满意.

目的 总结热带地区肺隐球菌病的宿主因素、临床特点、影像学特征及治疗预后,提高对肺隐球菌病诊治的认识.方法 回顾性分析2014年5月-2019年7月解放军总医院海南医院符合确诊标准的肺隐球菌病病例.结果 入选病例14例,男性9例,女性5例,平均年龄50.79(29～77)岁.起病症状多样,包括胸痛(5/14,35.71％),胸闷(3/14,21.43％),咳嗽、咳痰(2/14,14.29％),咯血(2/14,14.29％)等,4例(28.57％)无明显症状.所有病例均经病理确诊,初诊误诊率100％,易误诊为肺癌、细菌感染、结核,平均确诊时间32.36(5～233)天.肺CT影像学特点:病灶分布于左肺7例(50.00％),右肺4例(28.57％),双肺3例(21.43％);病灶可表现为大结节型(7/14,50.00％),小结节型(5/14,35.71％),实变/混合型(1/14,7.14％),空洞型(1/14,7.14％);可有分叶/毛刺、晕征、胸膜增厚/牵拉、纵隔淋巴结肿大等伴随表现.本研究中5例(35.71％)经外科手术切除病灶治愈,9例(64.29％)接受药物治疗,其中8例(57.14％)接受氟康唑单药治疗,7例(87.50％)治愈,1例(12.50％)好转;1例接受两性霉素B强化氟康唑序贯治疗后治愈.结论 肺隐球菌病可发病于热带地区非免疫抑制宿主,且多无鸽子接触史,起病症状多样,肺CT表现缺乏特异性,误诊率高,确诊主要依赖病理检查.手术治疗可治愈,药物治疗疗效确切,不良反应少,总体预后良好.

本文借鉴SARS病毒感染分型系统,建议将新型冠状病毒感染可分为隐匿型(已诊断、未诊断2个亚型)、顿挫型、轻症肺炎型、重症肺炎型、危重症肺炎型5个类型;或者隐匿型(已诊断、未诊断2个亚型)、顿挫型、肺炎型(轻症、重症、危重症3个亚型)3大类型.其中,轻症肺炎型、重症肺炎型和危重症肺炎型3个类型,分别对应目前通用分类的"普通型"、"重型"和"危重型".新型冠状病毒感染新的临床分型,强调了显性感染和隐形感染的区别,弥补了传统分型不能覆盖部分临床患者的缺陷,兼顾了临床特征中病情轻重和有无肺炎2个诊断维度,提出了未诊断感染者的隐匿亚型,对未来新型冠状病毒防控具有重要意义.

OBJECTIVE: To explore the changes of clinical symptoms, imaging features and related infection indexes of the Corona Virus Disease 2019 (COVID-19) and reveal its relationship with the change of viral nucleic acid load METHODS: A 31-year-old male patient who had a history of staying in the epidemic-affected area and a history of fever, cough, and sore throat was enrolled in the study, and the clinical symptoms, CT imaging features and laboratory test indexes of the patient were retrospectively analyzed RESULTS: The patient was tested twice for the nucleic acid at the onset, the symptoms disappeared quickly after treatment The lung CT was re-checked 14 days after the onset, the viral nucleic acid test showed positive after the re-test, and the patient was conformed as COVID-19 and was cured successfully During the course of the disease, the clinical symptoms and laboratory indicators were not parallel with the imaging findings CONCLUSION: Combined with the characteristics of the case whose symptoms and test indicators are not parallel with the imaging findings and the existing studies, it does not rule out that the COVID-19 has a growth and decline process during the in vivo replication process, and the difference in nucleic acid load at different stages in the course of the disease determines the result of nucleic acid test It is suggested that in the process of diagnosis and treatment, attention should be paid to the need for repeated test of nucleic acid, and when the symptoms improve and the virus nucleic acid re-test is positive, you should be highly vigilant of the possibility of aggravation of the symptom and the image

所谓新型冠状病毒肺炎,就是指严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)导致的2019冠状病毒疾病(2019 coronavirus disease,COVID-19).在最早确诊的41例COVID-19患者中,约有12％诊断为病毒相关的心脏损伤,主要表现为超敏心肌肌钙蛋白Ⅰ(hs-cTnI)水平上升(＞28 pg/mL),或者在心电图和超声心动图中出现新的异常[1].另有84例COVID-19患者在治疗过程中出现心肌损伤标志物的升高.还有138例COVID-19患者中10例发生了急性心脏损伤,8例为ICU患者(占ICU比例为22.2％),ICU患者的血hs-cTnI显著高于非ICU患者[2].且在近期发布的第五版和第六版《新型冠状病毒感染的肺炎诊疗方案》中均提出,有部分危重者可见血肌钙蛋白增高现象,并有不同学者认为这可能和爆发性心肌炎或心脏损伤有关[3-4].

目的 分析肺奴卡菌病临床特点和诊治方法,提高对肺奴卡菌病的诊治意识.方法 对2012年1月-2019年12月解放军总医院海南医院14例肺奴卡菌病住院患者临床资料进行回顾性分析,结合国内外文献,进行临床特点分析.结果 14例肺奴卡菌病患者均为原发肺奴卡菌感染,既往体健者7例,7例患有基础疾病;14例患者中表现为咳嗽、咳痰12例(85.7％),发热4例(28.6％),咯血2例(14.3％),气促2例(14.3％),胸痛2例(14.3％);肺CT影像主要表现为实变、斑片影、结节等;14例肺奴卡菌病患者,3例患者炎症指标中白细胞计数、中性粒细胞占比升高,7例患者C-反应蛋白水平升高,1例患者降钙素原水平升高;通过痰培养、肺穿刺组织、高通量基因测序等方法对奴卡菌感染进行诊断;治疗上以磺胺类药物为基础单药或联合治疗好转.结论 以肺为首发免疫正常肺奴卡菌病病例并不少见,临床表现类似于常见社区获得性肺炎,容易出现误诊、漏诊,痰弱抗酸染色、支气管灌洗、组织病理可帮助诊断,高通量基因测序可以快速帮助提高确诊率,磺胺甲噁唑/甲氧苄啶对于肺奴卡菌病疗效较好,耐药少,少数合并基础疾病病例需联合治疗,尽早明确诊断对预后良好.

2009甲型(H1N1pdm09)流感大流行后,几个单价大流行性流感疫苗通过快速程序被许可使用.发作性睡病作为疫苗的副作用被发现,主要是在接受用欧洲的灭活纯化协议生产的AS03佐剂A(H1N1)流感疫苗的人群.感染野生甲型(H1N1)大流行流感病毒后没有接种疫苗的人群,发作性睡病的发病也在增加,这提示此种病毒抗原的作用在发作性睡病疾病发展中具有一定作用.本文进行了发作性睡病背景简介,概述了流感疫苗制剂的不同类型,探讨了自身免疫性疾病和自然感染之间的关系.

Objective Retrospective analysis of the application by thoracoscopy for the diagnosis of patients with pleural effusion of unknown causes in our department since 2012,to prove that medical thoracoscopy plays an important role in diagnosis of the pleural effusion.Methods Review of the 17 cases with pleural effusion in respiratory department of the People′s Liberation Army general hospital,and sum up the experience of the case in the auxiliary examination and the treatment process.Results 17 patients by conventional inspection methods failed to confirm the diagnosis.After thoracoscopy,16 patients had clear diagnosis except one patient due to severe pleural adhesions.Including 10 cases of adenocarcinoma,four cases of tuberculosis,one case of multiple myeloma,one case of pleural mesothelioma.Conclusions Pleural effusion of unknown causes is relatively common, easily missed diagnosis and misdiagnosis. Thoracoscopy is an important means of pleural effusion diagnosis,to reduce the misdiagnosis and missed diagnosis.

Objective To analyze the diagnostic value of digital area medicine information cybernetic system (DAMICS) in diagnosing obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Seventy-six patients [male 64, female 12, with a mean age of (46.58±14.32)] with suspected OSAHS were monitored by DAMICS and polysomnography (PSG) for 7 h. The apnea hypopnea index (AHI) of PSG served as gold standard for the diagnosis of OASHS. The diagnostic value was evaluated by comparing PSG-AHI with DAMICS-AHI.Results There was no significant difference in mild patients according to groups of PSG-AHI (P>0.05). There was no significant difference in stertorous and mild patients according to groups of DAMICS-AHI (P>0.05). Significant positive correlation was found betweenDAMICS-AHI and PSG-AHI (r=0.967,P=0.000). With PSG-AHI≥5 as the diagnostic standard of OSAHS and PSG-AHI≥15 as diagnostic of severe OSAHS, receiver operating characteristic (ROC) curves were drawn. According to ROC curves, a cut-off point of 7.6 was identified as the best point for diagnosing OSAHS with sensitivity of 93.8% and specificity of 100%. Another cut-off point of 14.15 was identified as the best point for diagnosing severe OSAHS with sensitivity of 93.9% and specificity of 96.3%.Conclusion DAMICS is a valuable device with highly sensitivity and specificity in diagnosis of OSAHS.

胃食管反流病是指胃内容物反流至食管，引起相应的食管症状和（或）并发症的一种疾病。临床上由于胃食管反流、吸入胃内容物引起的肺炎并不少见，正常人由于喉保护性反射和吞咽的协同作用，一般食物和异物不易进入下呼吸道，即使误吸少量液体，亦可通过咳嗽排出。但当合并一些基础疾病时，防御功能减弱或消失，异物即可吸入气管；而老年人长期留置胃管反应性差也比较容易发生胃食管反流造成吸入性肺炎［1］。为了提高对该病的防治，回顾性分析解放军总医院2014年4月至2015年1月收治的20例胃食管反流所致吸入性肺炎患者的临床资料，并进行文献复习，现抱道如下。

目的:探讨隐源性机化性肺炎的临床表现、病理特点和影像学特征,以提高临床诊断率和救治水平.方法:回顾分析24例经肺穿刺加病理确诊的隐源性机化性肺炎患者,对其临床表现、肺功能检查、影像学表现、组织病理学、治疗和转归进行综合分析.结果:24例隐源性机化性肺炎患者临床表现以发热、干咳、喘息、活动后呼吸困难和肺部湿啰音为主.肺功能显示阻塞性通气功能障碍12例、限制性通气功能障碍10例、混合性通气功能障碍2例.24例患者中23例肺泡灌洗液均以淋巴细胞为主,只有1例以中性粒细胞为主,肺CT以双肺多发磨玻璃影、多变性、反晕征为主.病理提示机化性肺炎表现.患者均接受糖皮质激素治疗,随访3～12个月,病情均好转.结论:隐源性机化性肺炎的临床表现和影像学表现缺乏特异性,确诊有赖于临床表现-影像-病理特征的综合诊断,一般预后良好,糖皮质激素治疗有效.

Kartagener's综合征(kartagener's syndrome,KS)由支气管扩张、慢性鼻窦炎或鼻息肉、内脏反位三联征组成.主要表现为反复发生呼吸道化脓性感染、咯血为特征的支气管扩张症状及副鼻窦炎和右位心[1].笔者结合1例近期诊治患者并文献复习,现报告如下.