少见部位支气管内膜结核25例临床分析

目的 探讨中、下叶少见部位支气管内膜结核(EBTB)的临床特征及确诊手段.方法 分析25例经支气管镜检查诊断中、下叶EBTB的临床资料进行回顾性分析.结果 本组病例最主要症状是咳嗽.胸片各有6例出现空洞、肺不张.支气管镜检查镜下形态分型最常见是溃疡及干酪坏死型、再依次为瘢痕狭窄型、炎症浸润型、肉芽增生型.痰涂片、痰培养、刷检涂片、活检病理的阳性率分别为44%、44%、76%、5 3%.结论 对反复咳嗽或胸片有空洞、肺不张的患者应警惕EBTB,溃疡及干酪坏死是中、下叶EBTB最常见及特征性的支气管镜下表现.联合应用痰涂片、痰培养、刷检涂片、活检病理可明显提高诊断阳性率.

Clinical Analysis of 25 Cases with Endobronchial Tuberculosis in Middle and Lower Lobes

Objective To explore the clinical features and diagnosis of endobronchial tuberculosis (EBTB) in middle and lower lobes.Methods Clinical features of 25 cases with EBTB were studided retrospectively. Result Main symptoms was cough.6 cases in chest X-ray were cave and 6 cases in chest X-ray were atelectasis .Bronchoscopic results showed ulcerative lesions in 52% of the case,cicatricial lesions in 24% of the cases, exudative lesions in 12% of the cases,granulomatous lesions in 12% of the cases. Positive results were found in 11 out of 25 by sputum acid-fast staining,11out of 25 by sputum tubercle bacillus culture,19 out of 25 by bronchoscopic brushing smears,and 8 out of 15 by bronchial biopsies. Conclusions When patients with productive cough or chest X-ray showing cave or atelectasis, EBTB shoud be suspected. Ulcerative lesions is the most common and daignostic bronchoscoptic features of EBTB.Combined application of sputum acid-fast staining, sputum culture, bronchoscopic brushing smears and bronchial biopsies are beneficial to definite diagnosis of EBTB.