纤维支气管镜检查对老年人不典型肺结核的诊断价值

Diagnostic value of fibrobronchoscopy in atypical pulmonary tuberculosis in elderly

目的评价支气管镜术对老年人不典型肺结核的诊断价值。方法对５１例老年不典型肺结核患者在纤维支气管镜直视下获取标本进行病理学和细菌学检查。结果刷检直接涂片和支气管肺泡灌洗液经离心浓集涂片同时找到抗酸杆菌２７例（５２．９％）；活检经病理学检查呈结核病变８例（１５．８％）；刷检７例（１３．７％）、支气管肺泡灌洗液４例（７．８％）、吸引物３例（５．９％）及术后痰检２例（３．９％）分别找到抗酸杆菌。

Objective To assess the value of bronchoscopy in detecting atypical pulmonary tuberculosis in elderly.Methods Fibrobronchoscopy was performed in 51 old patients with atypical pulmonary tuberculosis and pathology and bacteriology of the specimens obtained were studied.Results Tubercle bacilli were found in 27 cases(52.9%) simultaneously from bronchial brushing matter and bronchoalveolar lavage fluid,tuberculous lesion in 8 cases(15. 8%) from biopsy specimens,tubercle bacilli in 7 cases(13.7%) from bronchial brushing matter,4 cases(7.8%) from bronchoalveolar lavage fluid,3 cases(5.9%) from aspirated matter,and 2 cases(3.9%) from sputum after bronchoscopy.Conclusions The results suggest that the bronchoscopy plays an important part in the diagnosis of atypical pulmonary tuberculosis in the elderly.