纤维支气管镜检查对不典型肺结核的诊断价值

Evaluation of Fiberoptic Bronchoscopy in the Diagnosis of Atypical Pulmonary Tuberculosis

本文报告46例痰菌阳性,胸片和(或)临床表现不典型,临床误诊为原发性和转移性肺癌、肺炎、肺不张及肺脓肿等的不典型肺结核的纤维支气管镜(纤支镜)检查结果。44例(95.7％)确诊为肺结核。其中42例刷检涂片,39例(92.9％)查到抗酸杆菌;39例活检,17例(47.7％)病理诊断为结核病。结果表明,纤支镜检查对不典型肺结核的诊断有肯定的价值。

In this paper, we report the results of fiberoptic bronchoscopy in 46 cases of pulmonary tuberculosis which were misdiagnosed as primary and metastatic carcinoma of lung, pneumonia, lobular and segmental atelectaxis of lung, pulmonary abscess, and hemoptysis owing to the atypical manifestations of chest film and/or clinical symptoms, negative sputum smear for acid-fast bacilli.The positive diagnosis was established in 44 of 46 patients (95.7%) via fiberoptic bronchoscopic brushing and biopsy Bronchoscopic brushing specimens were positive for the presence of acid-fast bacilli in 39 of 42 patients (92.9%).In 39 pathologic examination of endobronchial biopsy specimens, the tuberculosis 17(47.7%), chronic inflammation 21 and acute purulent inflammation 1 were disclosed.There were no bleeding, pneumothorax, dissemination of tuberculosis or other serious complications during or after fiberoptic bronchoscopy.