单纯性支气管内膜结核的纤维支气管镜检查分析

Diagnosis of simple endobronchial tuberculosis by fiberobronchoscopy

目的探讨纤维支气管镜诊断单纯性支气管内膜结核病的特点.方法应用EB-1530 T型电子纤维支气管镜对92例单纯性支气管内膜结核患者支气管进行活检、刷检及灌洗液检查.结果单纯性支气管内膜结核多见于年轻人25～35岁,好发于上叶尖后段、中叶(舌段)和下叶背段支气管,左肺多于右肺,镜下表现为充血水肿、干酪样坏死、管腔狭窄、溃疡肉芽等.活检、刷检、灌洗液的诊断阳性率分别为81.5%、30.4%、20.7%,其中活检阳性率与刷检、灌洗液比较有显著性差异(P＜0.05).结论纤维支气管镜检查为诊断单纯性支气管内膜结核的有效手段.

Objective To assess the efficacy of fibrobronchoscopy in diagnosis of simple endobronchial tuberculosis. Method Biopsy, brush biopsy and bronchoalvelar lavage fluid examination were performed in 92 patients with simple endobronchial tuberculosis using an electronic fibrobronchoscope. Results Simple endobronchial tuberculosis commonly occurred in young people (25-35 years of age), often developed in the superior lobe apicoposterior segment, middle lobe (ligule) and superior branch of the inferior lobe of the left lung. Under fibrobronchoscope, congested edema, caseous necrosis and ulcer granulation were observed in patients with simple endobronchial tuberculosis. The successful detection rates for biopsy, brush biopsy and bronchoalvelar lavage liquid examination were 81.5%, 30.4% and 20.7%, respectively. Conclusion Fiberobronchoscopy is effective for diagnosis of simple endobronchial tuberculosis.