经支气管镜介入诊疗支气管结核探讨

目的探讨支气管镜对支气管结核的诊疗价值。方法分析经病理或刷检涂片、痰细菌学检查证实的113例支气管结核的临床表现、支气管镜检查所见,以及经支气管镜介入治疗的不同方法,探讨治疗效果。结果本组平均年龄37.3岁,男女比例为1:2.05。在支气管镜下显示左侧多于右侧,镜下具有多形态,多部位特点。炎症浸润型32例(28.3%),溃疡或干酪坏死型41例(36.3%),肉芽增殖型28例(24.8%),瘢痕狭窄型11例(9.7%),管壁软化型1例,(0.9%)。不同的介入治疗方法治疗不同类型的支气管结核均获得良好疗效。结论支气管镜检查是诊断支气管结核的主要手段,支气管镜介入治疗是有效的局部治疗方法。

The investigation of bronchoscopy intervention on diagnosis and therapy of endobronchial tuberculosis

Objective To investigate the application value of bronchoscopy both on diagnosis and treatment of endobronchial tuberculosis (EBTB). Methods By analyzing the clinical manifestation, bronchoscope observations, 113 EBTB patients with bacteriology and pathology verification were investigated, and deferent interventional treatments by bronchoscope were applied to the patients according their types of EBTB.Results The mean age of 113 patients was 37.3 years old. Incidence between male and female was 1:2.05, indicating that the female had higher disease incidence than male. The left side bronchial was more often affected than the right, and EBTB had the common characteristic in various forms and at different sites. Among all 113 patients, inflammatory infiltration were 32 cases (28.3%), ulcer or caseous mecrosis type 41 cases (36.3%), granulation hyperplasia type 28(24.8%), scar stenosis type 11 (9.7%), and bronchial wall intenerate type 1 (0.9%) case. Observations showed the treatment effects were satisfied.Conclusion Bronchoscopy is the main and important method of diagnosing EBTB. The intervention treatment through bronchoscope is very effective for local therapy of many kinds of EBTB.