胸片正常的支气管内膜结核的诊断与治疗

目的探讨胸片正常的支气管内膜结核(EBTB)的临床诊断和治疗.方法回顾性分析20例胸片正常的EBTB患者的临床表现、诊断和治疗.结果症状主要包括:咳嗽20例,胸闷12例,发热3例,咯血2例,纤维支气管镜检查均发现异常,活动性的干酪样坏死型6例,充血水肿型3例,肿块型1例,颗粒型4例,溃疡型3例,非特异性支气管炎型3例,均行黏膜活检和刷检,经黏膜活检病理确诊8例(40%),刷检细菌学证实16例(80%),两者联合确诊20例(100%).全身抗结核化疗后症状缓解率达100%.结论纤维支气管镜在胸片正常的EBTB的诊断中具有重要地位;全身抗结核化疗对胸片正常的EBTB疗效好.

The clinical diagnosis and therapy of endobronchial tuberculosis with normal chest radiograph

Objective To explore the clinical diagnosis and therapy of endobronchial tuberculosis (EBTB) with normal chest radiograph.Methods Clinical symptom,the methods of diagnosis and therapy of 20 cases of EBTB with normal chest radiograph were retrospectively analyzed.Results Main symptoms were follows:cough in 20 cases,dyspnea in 12,fever in 3 and haemoptysis in 2.Abnormality was found in all cases by bronchoscopy,6 cases of actively caseating EBTB,3 cases of edematous-hyperemic EBTB,1 case of tumorous EBTB,4 cases of granular EBTB,3 cases of ulcerative EBTB,3 cases of nonspecific bronchitic EBTB.Mucosa biopsy and bacteriology confirmed the diagnosis of 14 cases and 16 cases,and the two methods confirmed the diagnosis of 20 cases.After general antituberculosis chemotherapy,the symptom improvable rate were 100%.Conclusions Fiberoptic bronchoscopy plays an important role in the diagnosis of EBTB with normal chest radiograph; general antituberculosis chemotherapy to patients of EBTB with normal chest radiograph is very effective.