微量支气管肺泡灌洗在菌阴肺结核诊断中的应用

目的　探讨微量支气管肺泡灌洗对菌阴肺结核的诊断价值。方法　对 18例临床高度怀疑肺结核的痰菌阴性患者行灌洗液为 4 0 ml的微量支气管肺泡灌洗 ,并对回收液涂片做抗酸杆菌检查、普通细菌培养、细胞学检查及术后痰涂片检查抗酸杆菌。并于术后 1周至 1月复查胸片。结果　微量支气管肺泡灌洗液 (BAL F)检查抗酸杆菌阳性率为 5 0 % ,联合术后痰涂片检查抗酸杆菌阳性率为 71.4 % ,与术前相比 ,差异有显著性 (P<0 .0 1)。术后无 1例出现并发症。结论　微量支气管肺泡灌洗对菌阴肺结核的诊断是一种安全实用的检查方法。

The diagnostic significance of trace bronchoalveolar lavage for bacteriological negative pulmonary tuberculosis

Objective To investigate the diagnostic significance of trace bronchoalveolar lavage (BAL) for patients of bacteriological negative pulmonary tuberculosis. Methods Eighteen patients of highly suspected pulmonary tuberculosis with sputum smear negative were examined by trace BAL. BAL were tested to find mycobacterium tuberculosis or cancer cell, and were cultured routinely. At the same time sputum smear was repeatedly done after BAL. Chest X-ray film was done for every patient after the trace BAL between one week and one month later. Results The positive rate of the trace BAL smear was 50%. The positive rate of the trace BAL and sputum smear after the examination was 71.4%. The latter was significantly higher than the former: P<0.01. No complication appeared. Conclusion The examination using the trace BAL is a safe and practical method in the diagnosis of bacteriological negative pulmonary tuberculosis.