支气管结核48例临床分析

目的：探索支气管结核的临床特征及诊断方法。方法：分析48例1995-2001年支气管结核临床表现，影像学及纤支镜检查结果。结果：48例患者中青年女性明显高于其他组占66.7%(32/48)，咳嗽42例（87.5％），咯血10例（20.8％），胸痛13例（27%），气促28例（58.3%），发热12例（25%），乏力盗汗19例（39.5%）。胸片及CT示：肺内浸润渗出性病灶32例（66.7），空调6例（12.5%），肺不张20例（41.7%），阻塞性肺炎18例（37.5%），肺门及纵隔淋巴结肿大9例（18%），痰涂片结核菌阳性率为37.5%，纤支镜刷检结核菌阳性率为45.8%，组织活检中57.5%证实为结核。结论：当有支气管结核临床表现时，应行胸部X线、CT检查，有条件者行张支镜检查，纤支镜检查是诊断支气管结核最重要的方法。

Clinical analysis of 48 cases with endobronchial tuberculosis

Objective To explore the clinical characteristic and diagnostic measures for endobronchial tuberculosis. Methods 48 cases of endobronchial tuberculosis admitted from 1995 to 2001 were analyzed based on clinical, chest X ray/CT scans and fiberoptic bronchoscopy (FB) data.Results Young female patients occupied 66.7% of the total and was significantly higher than other groups. Main symptoms were as follows:42 had cough(87.5%), 10 had hemoptysis(20.8%),13 had chest pain(27%), 28 had breathlessness(58.3%), 12 had fever(25%), 19 had asthenia and night sweat (39.5%). Chest X ray and CT demonstrated: 32 cases showed epituberculosis infiltration, 6 cases showed pulmorary cavity(12.5%) , 20 cases showed atelectasis(41.7%), 18 cases showed obstructive pneumonia (37.5%), 9 cases showed hilar lymphadenovarix. Positive sputum swear for acid fast bacilli(AFB) were 37.5%. Staining for AFB was 45.8% positive in bronchial washings and diagnosis was confirmed by bronchoscopic biopsy specimens in 57.5%. Conclusion We should select patients by chest X ray when they have clinical manifestation as described above and CT were examed for the observed lesions. Bronchoscopy was done when the patients was suspected. Bronchoscopy examination was the most important procedure for the diagnosis of endobronchial tuberculosis.