干酪坏死型支气管结核72例临床分析

Clinical analysis of 72 cases with active caseation endobronchial tuberculosis

目的了解干酪坏死型支气管结核(EBTB)的临床表现,电子气管镜下表现及胸部CT常规平扫表现的特点和该型的治疗预后。方法回顾性分析72例确诊为干酪坏死型EBTB的临床特点,电子支气管镜下直视特点及胸部CT常规平扫特点。结果干酪坏死型EBTB具有刺激性咳嗽,不同程度的发热,易并发肺部感染。实验室检查痰菌阳性率高,红细胞沉降率、C反应蛋白(CRP)高。电子支气管镜下较容易识别该型,胸部CT常规平扫对该型EBTB诊断率不高。积极治疗取得了一定的疗效。结论干酪坏死型EBTB具有一定的临床特点。电子支气管镜是发现干酪坏死型EBTB的主要方法。给予积极的治疗可以有一定的疗效,但具有难治性。

Objective To study the clinical features, bronchoscopy manifestations, CT manifestation, and prognosis of active caseation endobronchial tuberculosis （EBTB）. Methods Clinical symptoms, chest X-ray/ CT manifestations and fiberoptic bronchoscopic findings of 72 cases diagnosed with EBTB were analyzed retrospectively. Results Main features were as followed： stimulating cough, non-specific fever, increased risk of lung infection, high sputum positivity, increased erythrocyte sedimentation rate（ESR） and C-reactive protein （CRP）. CT is less effective than bronchoscopy to diagnose this type of EBTB. Active treatment could yield a positive resuit. Conclusion Active caseation endobronchial tuberculosis EBTB has specific clinical features. Bronchoscopy is the key method for detection. Active treatment may improve the outcome, however, difficulties are still existing in treating active caseation endobronchial tuberculosis.