电子支气管镜检查在菌阴肺结核中的诊断价值

目的探讨电子支气管镜检查在痰菌阴性肺结核中的诊断价值。方法回顾性分析60例菌阴肺结核患者的电子支气管镜检查结果,了解镜下表现及组织活检病理、支气管镜刷检涂片和术后痰涂片找抗酸杆菌3种不同取材方法对肺结核诊断的阳性率。结果 60例患者中54例镜检发现异常,电子支气管镜主要表现为黏膜充血水肿36.7%(22/60)、溃疡或干酪样坏死13.3%(8/60)、增厚粗糙6.7%(4/60)、管腔狭窄21.7%(13/60)及肉芽肿样结节11.7%(7/60)。组织活检、刷检涂片及术后痰涂片检查的阳性率分别是59.3%、66.6%和43.3%,全部病例均经电子支气管镜确诊,确诊率100%。结论电子支气管镜检查在菌阴肺结核诊断中有重要价值,可提高确诊率,减少误诊。

The Diagnostic Value of Electronic Bronchoscope in Pulmonary Tuberculosis Cases with Tubercle Bacillus Undetected

Objective To investigate the diagnostic value of electronic bronchoscope in pulmonary tuberculosis cases with tubercle bacillus undetected（uTB-PT）.Methods The results of electronic bronchoscope examinations of 60 patients with uTB-PT were retrospectively analyzed,in order to know the main presentations under electronic bronchoscope and the positive rate of diagnosis of pulmonary tuberculosis about pathological biopsy,bronchial brushing smear and sputum smear acid-fast stain test.Results Among 60 patients,macroscopic abnormality can be directly observed in 54 patients.The main presentations under electronic bronchoscope were hyperemia and mucosa swelling 36.7%（22/60）,ulcers or caseous necrosis 13.3%（8/60）,granulation hyperplasia 6.7%（4/60）,stenosis of lumen 21.7%（13/60） and granuloma-like nodules 11.7%（7/60）.The positive rates of pathological biopsy、brushing smear and sputum smear acid-fast stain test were 59.3% 、66.6%、43.3% respectively.All cases were examined by electronic bronchoscope.The final diagnosis rate was 100%.Conclusion Electronic bronchoscope examination has important diagnostic value in pulmonary tuberculosis cases with tubercle bacillus undetected.It can improve the final diagnosis rate and reduce misdiagnosis rate.