12例支气管内膜结核临床诊断分析

目的探讨支气管内膜结核（EBTB）的临床特点、胸部影像学改变及诊断方法，提高对该病的认识，减少临床漏诊及误诊。方法对12例经支气管镜检查确诊的EBTB患者进行回顾性分析。结果EBTBJN床特点以慢性咳嗽咳痰为主，伴有胸闷气促，胸痛，咯血及发热盗汗等。普通痰涂片查抗酸杆菌阳性率低，痰聚合酶链反应（PCR）检查敏感性高。胸部影像学表现以肺部斑片状病灶最多见，其次为肺不张，部分表现为支气管扩张，少部分患者无异常表现。本组所有病例均经支气管镜活检，刷片及灌洗液检查明确诊断。结论EBTB临床表现缺乏特异性，胸部CT诊断特异性不高，临床易出现漏诊及误诊。支气管镜检查是明确该病的有效手段，对疑似病例应及早检查。

Clinical analysis of 12 cases of endobronchial tuberculosis

Objective To explorer the clinical feature of endobronchial tuberculosis, chest radiographic changes and diagnosis methods,to improve the understanding of the disease, reduce the clinical missed diagnosis and misdiagnosis. Methods A retrospective analysis was made on 12 patients with endobroncbial tuberculosis diagnosed by bronchoscopy. Results The clinical features of chronic cough and expectoration, accompanied by chest tightness shortness of breath, chest pain, hemoptysis and fever, night sweats, etc.Common sputum smear check acid fast bacilli positive rate is low, sputum PCR inspection sensitivity is high.Chest CT manifestations with patchy lung lesions are most common, followed by pulmonary atelectasis, part of bronchiectasis, few patients without abnormal findings. All cases were confirmed by bronchoscopic biopsy, brush and lavage diagnosis. Conclusion The clinical features of endobronchial tuberculosis lack specificity, chest CT diagnostic specificity is not high, clinical prone to misdiagnosis and missed diagnosis. Bronchoscopy is an effective way to clear the disease, suspected cases should be check as soon as possible.