经纤支镜诊断46例支气管结核临床分析

目的　探讨纤维支气管镜在支气管内膜结核早期诊断中的作用。方法　 1995年 1月～ 2 0 0 2年 12月经纤维支气管镜 (纤支镜 )活检或刷检确诊支气管内膜结核 4 6例患者进行临床特点和纤支镜结果统计分析。结果　 4 6例病人均证实为支气管内膜结核。 8例痰涂片找抗酸杆菌阳性 ,38例行纤支镜刷检找抗酸杆菌阳性 ,11例活检证实为结核。纤支镜检查示炎症浸润型 4 1.3% ,增殖型 13.0 % ,狭窄闭塞型 2 6 .1% ,溃疡型 15 .3% ,正常 4 .3% ,纤支镜刷检阳性率高于痰涂片检查和活检 (P<0 .0 1)。结论　支气管内膜结核缺乏特异性临床表现 ,X- CT诊断价值不高 ,纤支镜检查成为支气管内膜结核早期诊断的主要措施。

Clinical analysis of 46 endobronchial tuberculosis patients bronchoscopy results

Objective To further investigate the role of bronchoscopic examination in the early diagnosis of endobronchial tuberculosis. Methods The analysis was performed on the data of 46 endobronchial tuberculosis cases diagnosed by bronchoscopic brushing smears and (or) biopsies pathology tests between January 1995 and December 2002. The data were analyzed by SPSS11.0. Results The positive results were found in 8 out of 46 by sputum acid-fast staining, 38 out of 46 by bronchoscopic brushing smears, and 11 out of 25 by bronchoscopic biopsies. The bronchoscopic results showed that 41.3% of all cases belonged to exudative lesions type, 13.0% to granulomatous lesions type, 26.1% to cicatricial lesions type, 15.3% to ulcerative lesions type, and 4.3% to normal type. According to bronchoscopic examination results, bronchoscopic brushing smears had more positive findings than bronchoscopic biopsies or sputum smears findings: P<0.01.Conclusion The clinical characteristics of endobronchial tuberculosis are non-specfic.X-CT has less values in the diagnosis. Bronchoscopic examination plays an important role in the early diagnosis of the disease.