经纤维支气管镜诊断支气管内膜结核47例分析

An Analysis of 47 Patients with Endobronchial Tuberculosis by Fiberobronchoscopic Diagnosis

报道经纤维支气管镜检查并最后确诊的４７例支气管内膜结核患者，其纤维支气管镜下形态表现多样性，以粘膜粗糙、充血最常见（占５５．３％），局部瘢痕狭窄（占２３．４％），部分（尤其老年人）可表现为腔内肿物（占２３．４％）易误诊为支气管肺癌。通过纤支镜检查、配合粘膜活检病理、刷检涂片找抗酸杆菌、检测结核菌ＤＮＡ，以及术后３天内留痰涂片查抗酸杆菌等检测手段可大大提高结核病的诊断率。重复纤支镜检查对结核与肿瘤的鉴别以及抗痨治疗效果的判定很有意义。

The Diagnostic Fiberobronchoscopy was performed in 47 patients with endobronchial tuberculosis. The bronchoscopic findings were diverse. In most of the cases, the mucous membrane showed rough and engored(55.3%) and lumen become cicatricially stenosis(23.4%), mucosa revealed neoplasm(23.4%), which mimiced lung carcinoma. Especially in tuberculosis the elderly patients must be differentiated from lung cancer. The tuberculosis diagnostic rate would be increased by the following combined examinations, such as the chest film, fiberobronchoscopy biopsy and bronchobrush sample for tuberculotic DNA by polymerase chain reaction(PCR) and the acid fast bacteria test of sputum with in 3 days post-fiberobronchoscopy.